Bodybuilding Death List

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Part 1

by Mike Arnold

Steroids, Cardiovascular Health, and Reversing the Trend, a Disturbing Trend . As BB’rs, many of us possess a natural propensity for extravagance. For some, the outward manifestation of this trait remains rooted in the achievement of their BB’ing goals, while others find themselves struggling to remain focused on the task at hand, instead succumbing to a lifestyle of destructive excess outside of the gym. While the former are often lauded for their steadfast determination and commitment to their goal, the truth is that they are equally prone to temptations of excess, which frequently finds an outlet in the abuse of performance enhancing drugs.

This is no surprise, as the quest for physical perfection to which BB’rs find themselves subject demands that one push the envelope in nearly every aspect of their lifestyle if maximum progress is desired. With a mental disposition ideally suited to the sport’s requirements, it is little wonder that drug use has continued to escalate over the years. A valid case could be made for this increase in dose over the first few decades, as science has since confirmed that the initial dosages employed by BB’rs did not allow for androgen receptor saturation. However, we eventually reached a point of diminishing returns and then, in an act of ignorance which demonstrated our ill-preparedness to responsibly wield the pharmacological advancements which had become available to us, we surpassed that point and ventured into a realm of unjustified abuse.

It is true that success in this sport carries with it a certain level of chemical risk, yet the degree of risk assumed is largely dependent on our own actions. Proper education leading to the responsible application of PEDs, in combination with routine health monitoring and preventative action, can greatly reduce our likelihood of developing health problems. Unfortunately, many approach this sport with a skewed mental outlook, a type of willful ignorance, if you will, and we are now starting to see the consequences of this type of behavior.

Show me the Bodies

It wasn’t long ago that pro-steroid advocate and writer John Romano, while making a case for steroid safety, pointed out his defense when he succinctly stated “show me the bodies”. Well, we’re now starting to see them. The number of bodybuilding related deaths reached a record high in 2013, with multiple high profile pro BB’rs passing away prematurely. In most cases the cause of death was the same—heart attack. Being the #1 cause of death in America for decades, cardiovascular disease is certainly nothing new, but when an unusually high percentage of people within a particular demographic begin having heart attacks in their 30’s-40‘s, especially when this population is exposed to lifestyle factors which are generally accepted as conducive to good cardiovascular health (regular exercise & healthy eating), one cannot help but point the finger at the obvious culprit.

Below is a partial compilation of pro BB’rs in their 30’s-40’s who have passed away within the last couple years due to heart attack…

Greg Kovacs
Daniele Saccerecci
Nasser El Sonbaty
Matt Duvall
Don Youngblood
Art Atwood
Frank Hillebrand
Edward Kawak

While the names above are recognizable to most BB’ing fans due to their semi-celebrity status, they do not adequately represent the vast number of amateur and non-competitive BB’rs who have succumbed to the same fate over the last several years. If we include both competitive and non-competitive strength athlete among this total, the number rises even higher.

It would be foolish to suggest that steroids alone are to blame, as the excessive bodyweight many of these individuals carry no doubt played a role in their untimely demise. Neither can we deny a potential genetic component in any of these cases. However, it is well known that AAS use can lead to side effects which are potentially injurious to one’s cardiovascular health. These include increased blood pressure, an altered lipid profile, and elevated hematocrit. In addition, steroids may cause cardiomegaly (an enlarged heart), as well as impaired cardiac function.

Recognizing the Problem

Blood pressure is defined as the force of blood against artery walls. When this pressure rises outside of a normal range and remains elevated we are said to have high blood pressure, or hypertension. This causes the heart to work harder to pump an equivalent amount of blood throughout the body. As the condition progresses the oxygen carrying capacity of the arteries is diminished, leading to the potential development of atherosclerosis and increasing the risk of heart disease, congestive heart failure, kidney disease, heart attack, and stroke.

There are two types of blood pressure; systolic and diastolic. Systolic pressure is the force of blood in the arteries as the heart beats, while diastolic is the pressure in the arteries when the heart is at rest. Although both types of blood pressure usually rise together, they do not always rise in equal proportion to one another. Regardless, both types of blood pressure are important and must be properly managed if we wish to maintain good cardiovascular health.

According to the medical community, Stage 1 hypertension is officially defined as any reading over 140/90. Stage 2 hypertension begins at 160/90 and is much more serious than Stage 1. Entry into Stage 1 is very common among AAS users and generally speaking, it is not cause for alarm under normal circumstances. However, it should serve as notice to stay vigilant and if necessary, steps should be taken to prevent a further increase.

Hematocrit, also known as PCV (packed-cell volume), is the concentration of red blood cells in the blood. The higher hematocrit is, the greater the percentage of red blood cells in the blood, while lower hematocrit levels signify a lower percentage of red blood cells. If hematocrit rises outside of the normal range (a condition known as polycythaemia) the blood becomes too thick, causing circulatory difficulties that may result in blood clotting issues, stroke, and heart disease.
With RBC’s being responsible for the delivery of oxygen, one might assume that a higher hematocrit level would necessarily lead to greater oxygenation of body tissues. However, this is not always the case. As the blood’s viscosity increases, especially beyond a certain point, it moves more sluggishly, which may prevent body tissues from receiving as much oxygen as they would with a more normal RBC count.

Lipids are fat-like substances necessary for normal physiological functioning in human beings. They are responsible for the repair of cell membranes, the formation of hormones, the creation of bile salts, and other functions. There are 3 primary components which make up our lipid profile. They are LDL cholesterol (bad cholesterol), HDL cholesterol (good cholesterol), and triglycerides. When LDL cholesterol levels become elevated, cholesterol is deposited on the walls of arteries and forms a hard substance called plaque. If steps are not taken to reverse this process, the arteries will continue to get narrower and narrower, decreasing overall blood flow and causing a condition known as atherosclerosis (commonly referred to as “hardening of the arteries).

Eventually, atherosclerosis may affect the coronary arteries (the blood vessels that supply oxygen to the heart) to the point where the heart is no longer able to receive adequate oxygen. This is called coronary artery disease and is the most common cause of heart attack. When this condition affects the brain it is known as cerebral vascular disease, which is associated with an increased risk of stroke.

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Part 2

In Part 1 we discussed the growing trend of steroid abuse and its consequences. In Part 2, we will begin learning how to protect ourselves from these side effects…Steroids, Cardiovascular Health, and Reversing the Trend.

Responsibility to the Responsible

As undesirable as these side effects may be, your decision to implement corrective/preventative action will have a significant impact on the degree to which these side effects manifest themselves, if at all. While some individuals have equated steroid use to Russian Roulette (thereby removing personal responsibility), history has shown that those individuals who ignore their cardiovascular health are at the greatest risk of developing one or more of these problems. Fortunately, the majority of these side effects, particularly those with a strong causative link to cardiovascular disease, are easily detectable and largely preventable.

For those who wish to adopt a pro-active stance towards this aspect of their health, the 1st step is a comprehensive assessment of the internal landscape via physician monitored bloodwork.

This initial evaluation allows us to diagnose any issues which may be present, thereby assisting us in putting together a treatment plan ideally suited to our needs. In addition to the cardiovascular system, bloodwork is also necessary for evaluating our renal (kidney), hepatic (liver), hormonal, and reproductive function. While whole-body health maintenance is always recommended, the end-point of cardiovascular disease, as well as the frequency with which it tends to occur in steroid users, should make its prevention a priority.

The best place to begin is by assessing the 3 primary cardiovascular health markers, which includes blood pressure, lipids, and hematocrit. While high blood pressure can be self-diagnosed with a simple at home blood pressure device (many pharmacies also offer free blood pressure readings), hematocrit and lipids problems cannot. A simple trip to your family doctor, followed by a visit to the lab, will provide you with the answers you seek (Note: As a general rule, I recommend that steroid users get bloodwork no less than once every 6 months, while heavier users may want to increase their frequency to once every 3-4 months).

By pin-pointing the problem we are no longer forced to rely on guesswork and can more accuaretly formulate a plan of attack. In most cases, changes in supplementation, drugs, and/or lifestyle are all it takes to bring these health markers back into range.

Enacting Change

The supplement market is filled with OTC products claiming to deliver various cardioprotective effects, but when deciding which to include in your program, how do you know which to choose? Above all, the product(s) you select should be clinically proven to deliver beneficial effects. Otherwise, how will you really know if the product does what it claims to do? Having met this prerequisite, you should prioritize your selection(s) according to your needs. All of the products listed below have been subjected to rigorous clinical testing with positive outcomes. Let’s begin with blood pressure products.

One of the most common is Hawthorne extract; a medicinal herb which has been used to treat various medical conditions since the 1st century AD. Today, it is a concentrated preparation containing 3 groups of active compounds (proanthocyanidins, flavonoids, and catechins), which are responsible for a number of beneficial effects, such as a reduction in liver fats, increased antioxidant activity, and reduced anxiety, but the most promising are its cardioprotective effects.

Some tend to view Hawthorne solely as a blood pressure supplement, but its cardioprotective effects are much more comprehensive and tailor-made for any steroid user. Hawthorne significantly increases blood flow to the heart muscle itself, thereby lowering the risk of heart attack (which is a direct result is poor heart muscle oxygenation). Hawthorne accomplishes this through multiple mechanisms, which include improved nerve signal transmission (improved heart contractility), a reduction in peripheral vascular resistance (lowered blood pressure), an improved lipid profile (better cholesterol values), and by providing an antiarrhythmic effect (restores a regular heartbeat). It may also increase the heart’s tolerance to oxygen deficiency.

Hawthorne is regularly used by the U.S. medical community to treat congestive heart failure, most frequently in conjunction with other therapies. In countries such as Brazil, France, Germany, and Russia, Hawthorne is categorized as an official drug. With an abundance of clinical evidence demonstrating Hawthorne’s ability to improve cardiovascular function, its inclusion in the programs of steroid users is a no-brainer. See below for one of many clinical trials available on this compound:

Promising hypotensive effect of hawthorn extract: a randomized double-blind pilot study of mild, essential hypertension.
Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, The University of Reading, Whiteknights, PO Box 226, Reading RG6 6AP, UK. [email protected]

Abstract

This pilot study was aimed at investigating the hypotensive potential of hawthorn extract and magnesium dietary supplements individually and in combination, compared with a placebo. Thirty-six mildly hypertensive subjects completed the study. At baseline, anthropometric and dietary assessment, as well as blood pressure measurements were taken at rest, after exercise and after a computer ‘stress’ test. Volunteers were then randomly assigned to a daily supplement for 10 weeks of either: (a) 600 mg Mg, (b) 500 mg hawthorn extract, (c) a combination of (a) and (b), (d) placebo. Measurements were repeated at 5 and 10 weeks of intervention. There was a decline in both systolic and diastolic blood pressure in all treatment groups, including placebo, but ANOVA provided no evidence of difference between treatments. However, factorial contrast analysis in ANOVA showed a promising reduction (p = 0.081) in the resting diastolic blood pressure at week 10 in the 19 subjects who were assigned to the hawthorn extract, compared with the other groups. Furthermore, a trend towards a reduction in anxiety (p = 0.094) was also observed in those taking hawthorn compared with the other groups. These findings warrant further study, particularly in view of the low dose of hawthorn extract used.

The second compound on our list is Coenzyme Q10. A staple in many BB’ing products, some of you will already be acquainted with this endogenously produced, vitamin-like substance. CoQ10 is necessary for basic cell functioning and provides potent antioxidant effects, particularly in the heart, in which it is found in higher quantities. Levels of this essential co-enzyme gradually decrease as we age, leading to speculation that replacement therapy may reduce the incidence of age-related cardiovascular damage. In addition, studies have shown that those suffering from cardiovascular conditions often have below average levels of this essential co-enzyme relative to their age group, which has caused many in the medical community to recommend CoQ10 as a preventative therapy.

Successful clinical trials evaluating the effects of CoQ10 in the treatment of congestive heart failure and elevated blood pressure have led to its extensive use in the U.S., Japan, Europe, and Russia for the treatment of these conditions. Its antioxidant activity may also help protect the heart from potentially heart damaging medications, stress, and sickness. Although technically an OTC product, CoQ10 is treated more like a drug than a supplement in many parts of the world and with good reason.

Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials.
Cardiac Surgical Research Unit, Alfred Hospital, Melbourne, Australia. [email protected]

Abstract

Our objective was to review all published trials of coenzyme Q10 for hypertension, assess overall efficacy and consistency of therapeutic action and side effect incidence. Meta-analysis was performed in 12 clinical trials (362 patients) comprising three randomized controlled trials, one crossover study and eight open label studies. In the randomized controlled trials (n=120), systolic blood pressure in the treatment group was 167.7 (95% confidence interval, CI: 163.7-171.1) mm Hg before, and 151.1 (147.1-155.1) mm Hg after treatment, a decrease of 16.6 (12.6-20.6, P<0.001) mm Hg, with no significant change in the placebo group. Diastolic blood pressure in the treatment group was 103 (101-105) mm Hg before, and 94.8 (92.8-96.8) mm Hg after treatment, a decrease of 8.2 (6.2-10.2, P<0.001) mm Hg, with no significant change in the placebo group. In the crossover study (n=18), systolic blood pressure decreased by 11 mm Hg and diastolic blood pressure by 8 mm Hg (P<0.001) with no significant change with placebo. In the open label studies (n=214), mean systolic blood pressure was 162 (158.4-165.7) mm Hg before, and 148.6 (145-152.2) mm Hg after treatment, a decrease of 13.5 (9.8-17.1, P<0.001) mm Hg. Mean diastolic blood pressure was 97.1 (95.2-99.1) mm Hg before, and 86.8 (84.9-88.8) mm Hg after treatment, a decrease of 10.3 (8.4-12.3, P<0.001) mm Hg. We conclude that coenzyme Q10 has the potential in hypertensive patients to lower systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by up to 10 mm Hg without significant side effects.

While there is no doubt that supplementation is a useful tool in the management of high blood pressure, a comprehensive approach is likely to yield superior results. This often requires going right to the source of the problem, which in many cases, originates with the individual’s PED program.

One of the primary causes of high blood pressure in steroid using BB’rs is water retention. This can be caused by either the steroid itself, or an increase in estrogen levels as a result of aromatization. While there is little we can do to reverse direct, steroid-induced water retention outside of discontinuation, estrogen induced water retention is another story.
While science has confirmed the role of estrogen in muscle growth, do not be fooled into thinking that excessive levels of estrogen will further expedite the muscle building process, as science has failed to establish any link between above normal levels of estrogen and muscle growth in males. On the other hand, water retention has the potential to dramatically elevate blood pressure, particularly in the more extreme cases.

There are no proven benefits associated with elevated estrogen levels, but we don’t need to look far in order to see the multiple, undesirable side effects associated with estrogen excess. Needless to say, as it stands right now, the evidence is heavily in favor of managing estrogen levels, which is most effectively done via an aromatase inhibitor. For this reason aromatase inhibiting drugs should be considered a basic ancillary item in any cycle which contains aromatizing AAS. In many instances this is all it takes to alleviate high blood pressure and bring one’s reading into a more acceptable range.

This section wouldn’t be complete without at least touching on cardiovascular exercise. It is no secret that most bodybuilders hate doing “cardio”. In the opinions of many, this heart healthy exercise is both boring and time consuming. So, if you needed another reason to start including it in your training program, perhaps the following will suffice. Just a short 20 minute session, when done at a sufficient intensity, has been shown to measurably reduce blood pressure shortly after completion. When 3-4 sessions are performed per week, long-lasting changes are noted, so long as its remains a part of one’s program.

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Part 3

Having concluded our discussion on blood pressure in Part 2, we will be moving onto the topic of using supplementation to maintain normal cholesterol values and concluding with a similar chapter on hematocrit…

In addition to blood pressure management, maintaining a balanced lipid profile, which is comprised of LDL cholesterol, HDL cholesterol, and triglycerides, should be at the top of your list. While total cholesterol levels are often used as a measure of lipid health, the ratio of LDL to HDL cholesterol is actually a more accurate indicator of cardiovascular risk, as HDL (the “good” cholesterol) helps to off-set the negative effects of LDL cholesterol on arterial health. Therefore, by simply increasing HDL levels in the blood, we can minimize (and potentially eliminate) the harmful effects of LDL on cardiovascular health.

Of all the different supplements on the market purported to improve one’s cholesterol profile, the majority are either ineffective or provide only marginal benefit. However, the same can’t be said of niacin (vitamin B3), which has held up under clinical scrutiny in dozens of studies. Being a plain old vitamin, you might be tempted to think of niacin as only moderately effective, yet research shows that niacin is capable of increasing HDL levels by a full 35%. Combined with its low cost, it is a must have supplement for any BB’r dealing with cholesterol issues.

Niacin and cholesterol: role in cardiovascular disease (review).
Atherosclerosis Research Center, Department of Veterans Affairs Healthcare System, Long Beach, California, USA.

Abstract

Niacin has been widely used as a pharmacologic agent to regulate abnormalities in plasma lipid and lipoprotein metabolism and in the treatment of atherosclerotic cardiovascular disease. Although the use of niacin in the treatment of dyslipidemia has been reported as early as 1955, only recent studies have yielded an understanding about the cellular and molecular mechanism of action of niacin on lipid and lipoprotein metabolism. In brief, the beneficial effect of niacin to reduce triglycerides and apolipoprotein-B containing lipoproteins (e.g., VLDL and LDL) are mainly through: a) decreasing fatty acid mobilization from adipose tissue triglyceride stores, and b) inhibiting hepatocyte diacylglycerol acyltransferase and triglyceride synthesis leading to increased intracellular apo B degradation and subsequent decreased secretion of VLDL and LDL particles. The mechanism of action of niacin to raise HDL is by decreasing the fractional catabolic rate of HDL-apo AI without affecting the synthetic rates. Additionally, niacin selectively increases the plasma levels of Lp-AI (HDL subfraction without apo AII), a cardioprotective subfraction of HDL in patients with low HDL. Using human hepatocytes (Hep G2 cells) as an in vitro model system, recent studies indicate that niacin selectively inhibits the uptake/removal of HDL-apo AI (but not HDL-cholesterol ester) by hepatocytes, thereby increasing the capacity of retained HDL-apo AI to augment cholesterol efflux through reverse cholesterol transport pathway. The studies discussed in this review provide evidence to extend the role of niacin as a lipid-lowering drug beyond its role as a vitamin.

The next compound on the list will be immediately recognizable to most PED users as an anti-gynecomastia agent, although a much smaller percentage of BB’rs are aware of its effect on cholesterol levels. In case you haven’t guessed, I am referring to the selective estrogen receptor modulator (S.E.R.M) known as Tamoxifen; also known as Nolvadex. Although Tamoxifen cannot claim OTC status, its regular inclusion in the programs of BB’rs, as well as its significant positive impact on cholesterol levels, is enough to warrant a place on this list of OTC cholesterol supplements.

Tamoxifen works by down-regulating cholesterol synthesis via inhibition of delta 8-cholestenol to lathosterol, ultimately reducing both LDL and total cholesterol. Interestingly, Toremifene, another S.E.R.M, works through the same mechanisms as Tamoxifen to improve the cholesterol profile. Clinical studies demonstrate nearly identical results between these two S.E.R.Ms, making either one equally suitable for cholesterol management.

While aromatase inhibitors have the upper-hand in terms of estrogen management, BB’rs afflicted with impaired cholesterol values might want to consider using Tamoxifen/Toremifene instead of an AI when trying to prevent of estrogenic induced side effects, as the benefits associated with improved cholesterol values may outweigh the benefits associated with systematic estrogen reduction in these individuals. Further strengthening this recommendation are clinical trials which show AI’s to be injurious to cholesterol values.

Tamoxifen and toremifene lower serum cholesterol by inhibition of delta 8-cholesterol conversion to lathosterol in women with breast cancer.
Department of Medicine, University of Helsinki, Finland.

Abstract

PURPOSE Long-term effects of tamoxifen and toremifene, a new antiestrogen that closely resembles tamoxifen, were investigated on serum lipids and cholesterol metabolism.
PATIENTS AND METHODS The study group consisted of 24 postmenopausal Finnish women with advanced breast cancer from an international multicenter study of 415 patients. Cholesterol metabolism was evaluated by measuring the cholesterol precursor (delta 8-cholestenol, desmosterol, and lathosterol, reflecting cholesterol synthesis) and plant sterol (markers of cholesterol absorption) and cholestanol levels by gas-liquid chromatography.

RESULTS Tamoxifen and toremifene lowered significantly serum low-density lipoprotein (LDL) cholesterol levels after 12 months of treatment by 16% and 15%, with no change in high-density lipoprotein (HDL) cholesterol or serum triglyceride levels. Serum delta 8-cholestenol was increased 40- and 55-fold during toremifene and tamoxifen treatment, respectively, while the increase of desmosterol less than doubled and was lacking for lathosterol by toremifene. Plant sterols and cholestanol were only inconsistently increased in serum.

CONCLUSION Tamoxifen and toremifene inhibit the conversion of delta 8-cholestenol to lathosterol so that serum total and LDL cholesterol levels are lowered by downregulation of cholesterol synthesis. Thus, inhibition of the delta 8-isomerase may be the major hypolipidemic effect of these agents. Reduced risk of coronary artery disease will probably occur also during long-term toremifene treatment, because the drug reduces cholesterol and its synthesis, similarly to tamoxifen.

Over the last 15 years, the general public’s awareness of the importance of omega 3 fatty acids has gradually increased, resulting in a sharp rise in fish oil sales across the country. With such a wide range of beneficial effects and a general deficiency of omega 3’s in the typical American diet, it is easy to see how this supplement got so popular, but it is the cardiovascular benefits which are of particular interest to steroid users.

The active ingredients in fish oil are the omega 3 fatty acids EPA & DHA, which have been clinically proven to reduce the risk of coronary heart disease, lower blood pressure, and alleviate hyperlipidemia (elevated triglycerides). Anecdotal evidence appears to confirm this position, as populations which consume a diet high in fatty fish have lower rates of heart disease. The “Eskimo Study” offers us further insight into this subject. Zeina Makhoul, a postdoctoral researcher in the Cancer Prevention Program of the Public Health Sciences Division at the Hutchinson Center, agrees. She says “Because Yup’ik Eskimos have a traditional diet that includes large amounts of fatty fish and have a prevalence of obesity that is similar to that of the general U.S. population, this offered a unique opportunity to study whether omega-3 fats change the association between obesity and chronic disease risk”.

After evaluating triglyceride and C-reactive protein (a marker of inflammation) levels of 330 people living in the Yukon Kuskokwim Delta region of southwest Alaska, in which 70% of the population was obese, the researchers came to a surprising conclusion. Those individuals with blood levels of DHA & EPA similar to those living in the lower 48 states had elevated levels of triglycerides and C-reactive protein, while those with high blood levels of DHA & EPA had triglyceride and C-reactive protein levels comparable to non-obese people.

The same phenomenon was observed in the Asian countries of Japan and China before the dietary habits of Americans’ pervaded their culture. The link between inflammation and heart disease (as well as other metabolic conditions) has been clearly established and with fatty fish being proven to significantly reduce whole-body inflammation, as well as reduce triglycerides by up to 40%, it would be foolish for any steroid user to forgo this inexpensive and readily available supplement.

Omega-3 fatty acids in inflammation and autoimmune diseases.
The Center for Genetics, Nutrition and Health, Washington, DC 20009, USA. [email protected]

Abstract

Among the fatty acids, it is the omega-3 polyunsaturated fatty acids (PUFA) which possess the most potent immunomodulatory activities, and among the omega-3 PUFA, those from fish oil-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)–are more biologically potent than alpha-linolenic acid (ALA). Some of the effects of omega-3 PUFA are brought about by modulation of the amount and types of eicosanoids made, and other effects are elicited by eicosanoid-independent mechanisms, including actions upon intracellular signaling pathways, transcription factor activity and gene expression. Animal experiments and clinical intervention studies indicate that omega-3 fatty acids have anti-inflammatory properties and, therefore, might be useful in the management of inflammatory and autoimmune diseases. Coronary heart disease, major depression, aging and cancer are characterized by an increased level of interleukin 1 (IL-1), a proinflammatory cytokine. Similarly, arthritis, Crohn’s disease, ulcerative colitis and lupus erythematosis are autoimmune diseases characterized by a high level of IL-1 and the proinflammatory leukotriene LTB(4) produced by omega-6 fatty acids. There have been a number of clinical trials assessing the benefits of dietary supplementation with fish oils in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. Many of the placebo-controlled trials of fish oil in chronic inflammatory diseases reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.

Red wine/red wine extract’s distinct and potent cardiovascular-protective effects have earned it a place on my “top supps” list for those BB’rs attempting to mitigate the damaging effects of steroids on the cardiovascular system. Red wine possesses antithrombic (protects against blood clots), antioxidant (protects against free-radicals), anti-ischemic (protects against atherosclerosis), vasorelaxant (widens blood vessels), and anti-hypertensive properties (reduces blood pressure), effectively protecting against arterial damage and reducing the risk of heart disease and heart attack.

Red wine’s cardioprotective effects are thought to be generated, at least in part, by a particular flavonoid called trans-resveratrol, which belongs to a group of compounds called polyphenols. While trans-resveratrol can be purchased by itself in supplement form, many believe that red wine’s full effects can only be procured by either drinking red wine or consuming red wine extract, as they contain the full complement of flavonoids found in red wine, which are thought to work synergistically to promote cardiovascular health.

As with fish oil, anecdotal evidence also supports the use of red wine/red win extract in the treatment and prevention of cardiovascular health problems. In similar fashion to the Eskimo study, populations which consume a large amount of red wine have been found to exhibit a lower rate of heart disease & heart attack. A perfect example of this is what is known as the “French Paradox”. Although the French consume a large amount of saturated fat, the incidence of coronary heart disease is significantly lower than other populations which consume a similar or even lower amount of saturated fat. The traditionally heavy red wine consumption of the French is believed to account for the decreased morbidity and mortality due to coronary artery disease.

Protective effects of red wine polyphenolic compounds on the cardiovascular system
Abstract

Phenolic phytochemicals are widely distributed in the plant kingdom. In terms of protective effects on organisms, the group of polyphenols is the most important. In various experiments, it has been shown that selected polyphenols, mainly flavonoids, confer protective effects on the cardiovascular system and have anti-cancer, antiviral and antiallergic properties. In coronary artery disease, the protective effects are due mainly to antithrombic, antioxidant, anti-ischemic and vasorelaxant properties of flavonoids. Flavonoids are low molecular weight compounds composed of a three-ring structure with various substitutions, which appear to be responsible for the antioxidant and antiproliferative properties. It has been hypothesized that the low incidence of coronary artery disease in the French population may be partially related to the pharmacological properties of polyphenolic compounds present in red wine. Many epidemiological studies have shown that regular flavonoid intake is associated with reduced risk of cardiovascular diseases.

Keywords: Anti-ischemic effect, Antioxidant activity, Antithrombic effect, Flavonoids, Polyphenols, Vasorelaxant properties
Consumption of diets high in saturated fat and cholesterol is usually associated with increased risk of cardiovascular disease. However, epidemiological evidence has shown that cardiovascular disease is less prevalent in the French population than expected in light of their saturated fat intake and serum cholesterol concentrations. This paradoxical finding has been attributed to regular consumption of fresh vegetables, fruit and red wine (1,2).

Law and Wald (3), however, predicted that it would be only a matter of time before the ‘French paradox’ resolved itself as the only recently comparable pattern of risk factors (animal fat consumption, serum cholesterol concentrations and blood pressure) between France and Britain would be translated into similar death rates from coronary disease. Although red wine consumption remains higher in France than in Britain, the authors rejected this as a possible explanation because they consider that wine intake greater than one unit a day confers no greater benefit (3). The protective effect of moderate consumption (two to three units) of red wine on the risk of cardiovascular disease morbidity and mortality, however, has been consistently shown in many epidemiological studies (reviewed in 2). Phenolic compounds and especially a group of flavonoids seem to be responsible for the majority of protective effects of red wine. A major activity of plant polyphenols is their antioxidant properties, which may explain many of their beneficial effects on cardiovascular function (4–6). Polyphenols also act on other targets involved in the metabolism of mammalian cells, including nitric oxide (NO), which regulates hemostasis (6,7), thrombus development (8) and vascular tone (9,10). The beneficial properties of NO may therefore explain in part the anti-ischemic activities of plant polyphenols.

This mini-review describes the protective effects of red wine polyphenolic compounds on cardiovascular disease, particularly their antithrombic, antioxidant, anti-ischemic, vasorelaxant and antihypertensive properties.

Moving on from cholesterol-lipids, we are going to conclude by addressing the final cardiovascular health marker; hematocrit. While several of the above compounds have been proven to reduce the incidence of blood clots (thereby reducing the level of danger associated with elevated hematocrit), we should still place ample emphasis on the management of this important health marker, as AAS use increases the risk of experiencing serious elevations in hematocrit. Prior to the arrival of EPO, Anadrol was the primary treatment for anemia—a condition characterized by a failure to produce adequate red blood cells. Even moderate steroid use has the potential elevate hematocrit into a dangerous range, so this is not something we can afford to ignore.

In comparison to blood pressure and lipids supplements, we are left with a relative lack of hematocrit modulating products on the OTC market. Fortunately, the few that are available are backed with clinical support. One of these is naringin, the flavonoid found in grapefruit that is responsible for imparting its characteristic bitter taste.
In clinical trials, naringin was shown to reduce hematocrit levels in those with elevated hematocrit, but in those with normal levels, it has no effect. This inherent ability to be selective in its actions depending on need is unique and something prescription drugs can’t offer. Its lack of side effects further increases its appeal over prescription drugs.
As a final consideration, users of naringin should be aware that the compound is capable of slowing the metabolic breakdown of certain drugs by interfering with enzymatic activity in the intestines. This can potentially result in higher than intended blood levels of prescribed medications, including calcium channel blockers and cholesterol-lowering drugs, as well as certain medications used to treat allergies and AIDS.

Ingestion of grapefruit lowers elevated hematocrit in human subjects.
Robbins RC, Martin FG, Roe JM.

Food Science and Human Nutrition Department, IFAS, University of Florida, Gainesville.

Abstract

This study was based on in vitro observations that naringin isolated from grapefruit induced red cell aggregation and evidence that clumped red cells are removed from the circulation by phagocytosis. The effect on hematocrits of adding grapefruit to the daily diet was determined using 36 human subjects (12 F, 24 M) over a 42-day study. The hematocrits ranged from 36.5 to 55.8% at the start and 38.8% to 49.2% at the end of the study. There was a differential effect on the hematocrit. The largest decreases occurred at the highest hematocrits and the effect decreased on the intermediate hematocrits; however, the low hematocrits increased. There was no significant difference between ingesting 1/2 or 1 grapefruit per day but a decrease in hematocrit due to ingestion of grapefruit was statistically significant at the p less than 0.01 level.

A Step in the right Direction

While PED use is a fairly safe practice when engaged in responsibly (meaning low-moderate dosages at infrequent intervals), those who choose to engage in heavy, chronic, long-term use (a near necessity for a competitive BB’rs at the national level and above) run a much greater risk of developing serious cardiovascular side effects, including heart attack and stroke. We are seeing the result of this abuse right now, with new names being added to the deceased list on a regular basis. Dying or being disabled in your 30’s, 40’s, or even 50’s, especially when it could have been prevented by taking a few simple steps, should be completely unacceptable to every steroid user. For those with wives and/or children, consider how your premature departure or disablement would affect your family.

The bottom line is that anyone who is trying to maximize his development is going to be at risk…and it is not only the drugs which can hurt you. The excessive bodyweight of many steroid users, whether it is fat or muscle, further increases the stress on the heart. With all this working against you, does wisdom not call for at least a modicum of preventative care? It does not cost much to use the supplements I listed above…and even a few of them are better than none at all.
In Advanced Cycle Support, IML offers a comprehensive product designed specifically for steroid users, which has been formulated to provide cardiovascular, liver, kidney, and prostate support in the form of hawthorne extract, co-enzyme Q10, grape seed extract, milk thistle, N-acetyl-cysteine, celery seed concentrate, and saw palmetto—all in clinically proven dosages. IML’s “Essence EFA” is a concentrated fish oil product produced under the most stringent standards to ensure you get the purest & freshest product available. When used in combination with Advanced Cycle Support, you will be getting over a half dozen of the most effective on-cycle protection products money can buy.

[jack tors]

"In Advanced Cycle Support, IML offers a comprehensive product designed specifically for steroid users, which has been formulated to provide cardiovascular, liver, kidney, and prostate support in the form of:"

hawthorne extract
co-enzyme Q10
grape seed extract
milk thistle
N-acetyl-cysteine
celery seed concentrate
saw palmetto
Fish oil

"IML’s “Essence EFA” is a concentrated fish oil product produced under the most stringent standards to ensure you get the purest & freshest product available.
When used in combination with Advanced Cycle Support, you will be getting over a half dozen of the most effective on-cycle protection products money can buy."

[jack tors]

Good post
Thanks

[Bouncer]

Yea it's pretty much a new commandment. If your on AAS you need to be taking fish oil at high doses. The evidence is clear especially those with high blood pressure, fish oil at 2-3 grams has a profound effect. Based on all the research I've read it's the single most important supplement a bodybuilder on AAS should be on. Unlike most supplements it has clear evidence showing significant results in people with high blood pressure.