Other Body Building Drugs

Other drugs may be used by body builders (93), including tamoxifen to reduce or prevent gynecomastia; diuretics to counteract the fluid retention caused by anabolic steroids; thyroxine to increase the rate of metabolism, which might theoretically increase the ability of anabolic steroids to boost physical strength (94); and P human chorionic gonadotrophin to alleviate testicular atrophy (95). Nalbuphine (Nubain) is an opioid agonist/antagonist analgesic used for the treat ment of moderate-to-severe pain, and dependence has been reported associated with anabolic steroid use (96).

Furthermore, there has been a case report of a 21-year-old body builder who was admitted after taking excessive amounts of insulin intravenously; apparently, insulin is advertised in body-building magazines as having anabolic properties (97). The recreational use of caffeine to toxic levels has been reported in a body builder who presented with a grand mal seizure (98). Clenbuterol, which is a sympathomimetic agonist (used as a oral bronchodila-tor in some European countries but not licensed for human use in the United Kingdom or United States) is said to have an "anabolic-like" effect but at high dose may cause cardiac dysrhythmias, tremor, and serious hypokalemia (99).

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