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Abstract
Background: Since its discovery in 1935, numerous derivatives of testosterone have been synthesized,
with the goals of prolonging its biological activity in vivo, producing orally active
androgens, and developing products, commonly referred to as anabolic-androgenic steroids
(AAS), that are more anabolic and less androgenic than the parent molecule.
Objective: This article reviews the structure, biotransformation, and mechanism of action of
testosterone and some of the most commonly used AAS. Clinical applications of the
AAS are discussed, and guidelines and therapeutic maneuvers for minimizing their side
effects are outlined.
Methods: Literature for inclusion in this review was identified using the libraries of the
University of Wisconsin Medical School and School of Pharmacy, the author's files,
and searches of MEDLINE, Science Citation Index, Biological Abstracts, and Chemical
Abstracts.
Results: The myotrophic action of testosterone and its derivatives and their stimulatory effects
on the brain have led to widespread use of AAS by athletes and “recreational” drug
users. Consequently, all AAS were classified as class III controlled substances in
1991. Nonetheless, AAS have shown benefit in a variety of human disorders, including
HIV-related muscle wasting and other catabolic conditions such as chronic obstructive
pulmonary disease, severe burn injuries, and alcoholic hepatitis. Because of their
diverse biological actions, AAS have been used to treat a variety of other conditions,
including bone marrow failure syndromes, constitutional growth retardation in children,
and hereditary angioedema. AAS therapy is associated with various side effects that
are generally dose related; therefore, illicit use of megadoses of AAS for the purpose
of bodybuilding and enhancement of athletic performances can lead to serious and irreversible
organ damage. The most common side effects of AAS are some degree of masculinization
in women and children, behavioral changes (eg, aggression), hepatotoxicity, and alteration
of blood lipid levels and coagulation factors.
Conclusions: To minimize or avoid serious toxicities with AAS therapy, close medical supervision
and periodic monitoring are important, with dose adjustment as appropriate to achieve
the minimum effective dose. Given the biological effects and potential adverse effects
of AAS, administration of these agents should be avoided in pregnant women, women
with breast cancer or hypercalcemia, men with carcinoma of the prostate or breast,
and patients with nephrotic syndromes or significant liver dysfunction.
Keywords
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References
- aÜber des Testosteron, des Kristallisierte Männliche Hormon aus Steerentestes.Acta Brev Neerland Physiol Pharmacol Microbiol. 1935; 5: 85-86
- bÜber des Testosteron, des Kristallisierte Männliche Hormon aus Steerentestes.Acta Brev Neerland Physiol Pharmacol Microbiol. 1935; 5: 108
- Über Androstendion, einen hochwirksamen männlichen Pragungsstoff.Hoppe Seylers Z Physiol Chem. 1935; 237: 75-88
- Über die Umwandlung des Dehydroandrosterons in Δ4-Androstenol-(17)-on(3) (Testosteron).Ber Dtsch Chem Ges. 1935; 68 (un Weg zur Darstellung des Testosterons aus Cholesterins (Vorlauf Mitteilung)): 1859-1862
- Über die Krystallische Herstellung des Testikelhormons, Testosteron (Androsten-3-on-17-ol).Helv Chim Acta. 1935; 18: 1264-1275
- Anabolic steroids and athletics.Exerc Sport Sci Rev. 1980; 8: 149-202
- Anabolic steroids are fool's gold.Fed Proc. 1981; 40: 2682-2688
- Anabolic steroids in athletics: How well do they work and how dangerous are they?.Am J Sports Med. 1984; 12: 31-38
- Anabolic steroids: A review of the literature.Am J Sports Med. 1984; 12: 469-484
- Epidemiological and policy issues in the measurement of the long term health effects of anabolic-androgenic steroids.Sports Med. 1989; 8: 129-138
- Androgenic-anabolic steroid use in adolescents.J Pediatr Health Care. 1989; 3: 175-180
- Anabolic steroid use in adolescent athletes.Pediatr Clin North Am. 1990; 37: 1111-1123
- Steroids: Breakfast of champions.Pediatr Rev. 1990; 12: 103-105
- Anabolic steroid abuse.Adv Pediatr. 1990; 37: 185-205
- Cardiac dysfunction in athletes receiving anabolic steroids.DICP. 1990; 24: 1060-1061
- Anabolic steroid—induced tendon pathology: A review of the literature.Med Sci Sports Exerc. 1991; 23: 1-3
- Anabolic steroids in the athlete.Annu Rev Med. 1991; 42: 449-457
- Use and abuse of anabolic and other drugs for athletic enhancement.Adv Intern Med. 1991; 36: 399-424
- Anabolic steroids: A review of their effects on the muscles, of their possible mechanisms of action and of their use in athletics.J Steroid Biochem Mol Biol. 1992; 43: 469-477
- aAnabolic-androgenic steroids and the adolescent.Pediatr Ann. 1992; 21: 175
- bAnabolic-androgenic steroids and the adolescent.Pediatr Ann. 1992; 21: 183
- cAnabolic-androgenic steroids and the adolescent.Pediatr Ann. 1992; 21: 186-188
- Anabolic-androgenic steroids and psychiatric-related effects: A review.Can J Psychiatry. 1992; 37: 23-28
- Anabolic-androgenic steroids and athletes: What are the issues?.J Clin Endocrinol Metab. 1992; 74: 465-469
- A review of anabolic steroids: Uses and effects.J Sports Med Phys Fitness. 1991; 31: 618-626
- Anabolic-androgenic steroids: Use and abuse.Compr Ther. 1993; 19: 69-72
- Anabolic steroids and growth hormone.Am J Sports Med. 1993; 21: 468-474
- Weight training. A potential confounding factor in examining the psychological and behavioural effects of anabolic-androgenic steroids.Sports Med. 1994; 18: 309-318
- Psychological and behavioural effects of endogenous testosterone and anabolic-androgenic steroids. An update.Sports Med. 1996; 22: 367-390
- Steroid abuse in female athletes.Curr Opin Obstet Gynecol. 1997; 9: 181-186
- Issues in detecting abuse of xenobiotic anabolic steroids and testosterone by analysis of athletes' urine.Clin Chem. 1997; 43: 1280-1288
- Adolescents and anabolic steroids: A subject review.Pediatrics. 1997; 99: 904-908
- Anabolic agents.Clin Sports Med. 1998; 17: 261-282
- Performance enhancing drugs (doping agents) and sudden death—a case report and review of the literature.Int J Leg Med. 1998; 111: 261-264
- The 5α-reduction of testosterone in the neuroendocrine structures. Biochemical and physiological implications.Endocr Rev. 1982; 3: 1-25
- The 5α-reductase in the brain: Molecular aspects and relation to brain function.Front Neuroendocrinol. 1992; 13: 163-215
- The intranuclear metabolism of testosterone in the accessory organs of reproduction.Recent Prog Horm Res. 1970; 26: 309-336
- Steroid Δ4-reductase. Their physiological role and significance.in: Hobkirk R Steroid Biochemistry. 1. CRC Press, Boca Raton, Fla1979: 1-27
- Sexualhormone X Herstellung des 17-Methyltestosteron und anderer Androsten und Androstanderivate. Zusammenhänge zwischen chemischer Konstitution und männlicher Hormonwirkung.Helv Chim Acta. 1935; 18: 1487-1498
- Hydroaromatic steroid hormones. 10-Nortestosterone.J Chem Soc. 1950; : 367-368
- The facile synthesis of 19-nortestosterone and 19-norandrostendione from estrone.J Am Chem Soc. 1953; 75: 5366-5369
- Urinary metabolites of administered 19-nortestosterone.J Biol Chem. 1958; 231: 159-165
- Aromatization of 19-norandrogens by equine testicular microsomes.J Biol Chem. 1987; 262: 5717-5722
- 2-Oxasteroids: A new class of biologically active compounds.Tetrahedron Lett. 1962; : 365-371
- Oxandrolone disposition and metabolism in man.Clin Pharmacol Ther. 1973; 14: 862-869
- Steroids CV 2-methyl and 2-hydroxymethylene-androstane derivatives.J Am Chem Soc. 1959; 81: 427-432
- Studies on anabolic steroids. GC/MS characterization of unusual seco acidic metabolites of oxymetholone in human urine.J Steroid Biochem Mol Biol. 1992; 42: 229-242
- Studies on anabolic steroids. 10. Synthesis and identification of acidic urinary metabolites of oxymetholone in a human.Steroids. 1992; 57: 453-459
- Steroidal-(3,2-c)-pyrazoles.J Am Chem Soc. 1959; 81: 1513-1519
- Metabolism of stanozolol: Identification and synthesis of urinary metabolites.J Steroid Biochem. 1990; 36: 153-174
- Metabolism of anabolic androgenic steroids.Clin Chem. 1996; 42: 1001-1020
- The effect of male hormone on the protein and energy metabolism of castrated dogs.J Nutr. 1935; 10: 437-459
- The relationship of synthetic male hormone, androstenedione, to the protein and energy metabolism of castrate dogs and the protein metabolism of a normal dog.Am J Physiol. 1936; 117: 642-657
- Testosterone and testosterone acetate and the protein and energy metabolism of castrate dogs.Endocrinology. 1937; 21: 750-755
- The effect of testosterone propionate on nitrogen, electrolyte, water and energy metabolism in eunuchoidism.Endocrinology. 1938; 23: 135-153
- Definition of androgens and protein anabolic steroids.Pharmacol Ther [B]. 1975; 1: 149-177
- Adverse effects of anabolic steroids.Med Toxicol Adverse Drug Exp. 1989; 4: 254-271
- Comparative myotrophic and nitrogen retaining effects of several steroids.Endocrinology. 1960; 67: 849-854
- A comparison of the myotropic and androgenic activities of the phenylpropionates and decanoates of testosterone and nandrolone.Acta Endocrinol. 1961; 38: 285-292
- Relative potency of various steroids in an anabolic-androgenic assay using the castrated rat.Endocrinology. 1963; 72: 259-266
- Anabolic activity of 2-oxa-17α-methyldihydrotestosterone (oxandrolone) in castrated rats.Steroids. 1964; 4: 689-697
- Biological actions of androgens.Endocr Rev. 1987; 8: 1-28
- Characterization of the androgen receptors in the skeletal muscle of the rat.Steroids. 1976; 28: 261-274
- Characterization and quantification of the androgen and glucocorticoid receptors in cytosol from rat skeletal muscle.Eur J Biochem. 1980; 111: 603-616
- Regulation of the androgen and glucocorticoid receptors in rat and mouse skeletal muscle cytosol.Endocrinology. 1981; 108: 1431-1440
- Relative binding affinity of anabolic-androgenic steroids: Comparison of the binding to the androgen receptors in skeletal muscle and prostate as well as to sex hormone—binding globulin.Endocrinology. 1984; 114: 2100-2106
- Modulation of the cytosolic androgen receptor in striated muscle by sex steroids.Endocrinology. 1984; 115: 862-866
- In vitro metabolism of 5α-dihydrotestosterone to 5α-androstane-3α, 17β-diol in rat heart, diaphragm, skeletal muscle and bulbocavernous/levator ani: Enzyme characterization and quantification.J Steroid Biochem. 1980; 13: 917-924
- Regulation and compartmentalization of androgens in the rat prostate and muscle.J Steroid Biochem. 1983; 19: 929-937
- Endocrine aspects of anabolic steroids.Clin Chem. 1997; 43: 1289-1292
- Glucocorticoid antagonism by exercise and androgenic-anabolic steroids.Med Sci Sports Exerc. 1990; 22: 331-340
- Comparison of protein anabolic property of various androgens in the castrated rat.Am J Physiol. 1950; 160: 53-67
- A comparative study of the metabolic effects of testosterone propionate in normal men and women and in eunuchoidism.Endocrinology. 1940; 26: 26-45
- Effect of testosterone on muscle mass and muscle protein synthesis.J Appl Physiol. 1989; 66: 498-503
- Anabolic steroid: Effect on strength development.Science. 1969; 164: 957-959
- Weight, size, and strength—unchanged with steroids.Phys Sportsmed. 1974; 2: 39-43
- Effects of an androgenic-anabolic steroid on strength development and plasma testosterone levels in normal males.Med Sci Sports. 1974; 6: 203-208
- The effects of an anabolic steroid on the strength, body composition, and endurance of college males when accompanied by a weight training program.Med Sci Sports. 1973; 5: 272-276
- Anabolic steroid effects on body composition in normal young men.J Sports Med Phys Fitness. 1971; 11: 98-103
- Influence of methyl testosterone on muscular work and creatine metabolism in normal young men.J Clin Endocrinol. 1942; 2: 649-654
- Human strength and endurance responses to anabolic steroid and training.J Sports Med Phys Fitness. 1977; 17: 285-296
- Effects of androgenic-anabolic steroids on neuromuscular power and body composition.J Appl Physiol. 1983; 54: 366-370
- Biochemical and physical effects of an anabolic steroid in competitive swimmers and weightlifters.Nutr Rep Int. 1970; 2: 351-362
- The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men.N Engl J Med. 1996; 335: 1-7
- Testosterone replacement increases fat-free mass and muscle size in hypogonadal men.J Clin Endocrinol Metab. 1997; 82: 407-413
- Androgens and erythropoiesis.N Engl J Med. 1973; 289: 72-80
- Hormonal factors influencing erythropoiesis.Acta Haematol. 1954; 11: 203-222
- The effect of sex hormones on the anemia induced by hemorrhage in the rat.Endocrinology. 1944; 35: 267-277
- Effect of sex hormones on erythrocyte number in the blood of the domestic fowl.Am J Physiol. 1943; 138: 479-487
- The effects of castration and cryptorchidization on the blood picture of the golden hamster.Anat Rec. 1944; 88 (Abstract): 459
- Effects of castration and sex hormones on blood of the rat.Proc Soc Exp Biol Med. 1941; 48: 169-177
- Effects of hypophysectomy, castration, and testosterone propionate on hemopoiesis in the adult male rat.Endocrinology. 1946; 39: 401-413
- Influence of age and sex on hemoglobin: A spectrophotometric analysis of nine hundred and nineteen cases.Arch Intern Med. 1916; 18: 505-528
- Variation of the hemoglobin level with age and sex.Blood. 1954; 9: 999-1007
- The cause of the sexual differences in erythrocyte, hemoglobin and serum iron levels in human adults.Blood. 1950; 5: 874-875
- Congenital adrenal hyperplasia associated with polycythemia.Pediatrics. 1959; 23: 727-730
- A note on the effect of certain androgens upon red blood cell count and upon glucose tolerance.Cleve Clin Q. 1941; 8: 79-84
- Increased erythropoiesis induced by androgenic hormone therapy.N Engl J Med. 1957; 256: 719-726
- The role of puberty in red-cell production in hereditary haemolytic anaemias.Br J Haematol. 1969; 17: 335-342
- Mechanism of action of androgens on erythropoiesis.Am J Physiol. 1966; 210: 315-320
- Further studies on the erythropoietic effect of androgens.J Lab Clin Med. 1965; 65: 775-782
- Use of mild plethora to demonstrate an erythropoietic effect from small amounts of androgens.Proc Soc Exp Biol Med. 1965; 120: 519-523
- Mechanism of testosterone action in erythropoiesis.Nature. 1965; 206: 270-272
- The erythropoietic-stimulating effects of androgens.Ann New York Acad Sci. 1968; 149: 356-365
- Inhibition of erythropoietic effects of hormones by erythropoietin antisera in mildly plethoric mice.Proc Soc Exp Biol Med. 1967; 126: 97-103
- Inhibition of erythropoietic stimulation by testosterone in polycythemic mice receiving anti-erythropoietin.Proc Soc Exp Biol Med. 1966; 122: 402-403
- Erythropoietin excretion in man following androgens.J Lab Clin Med. 1967; 70: 777-785
- Erythropoietin and erythropoiesis in anemic man following androgens.Blood. 1969; 33: 564-572
- Effects of testosterone on erythropoietin production in isolated perfused kidneys.Am J Physiol. 1970; 218: 1732-1736
- Effects of testosterone and of cobalt on erythropoietin production by anephric rats.J Lab Clin Med. 1969; 74: 623-629
- Further observations on the mechanism by which androgens and growth hormone influence erythropoiesis.Ann New York Acad Sci. 1968; 149: 298-307
- Effects of large doses of androgen on rodent erythropoiesis and body composition.Blood. 1965; 26: 411-420
- Ribosomes of mouse kidney: Regulation by androgens.Am J Physiol. 1969; 217: 383-391
- Oxymetholone treatment for the anemia of bone marrow failure.Blood. 1972; 40: 353-365
- Tissue culture of bone marrow. II. Effect of steroid hormones on hematopoiesis in vitro.Blood. 1966; 27: 460-469
- Effect of steroids on the cycling of haemopoietic stem cells.Nature. 1970; 228: 1204
- Steroid control of porphyrin and heme biosynthesis: A new biological function of steroid hormone metabolites.Proc Natl Acad Sci U S A. 1967; 57: 1463-1467
- Stimulation of hemoglobin synthesis in chick blastoderms by certain 5β androstane and 5β pregnane steroids.Proc Natl Acad Sci U S A. 1967; 58: 985-990
- Studies on the control of hemoglobin synthesis: The in vitro stimulating effect of a 5β-H steroid metabolite on heme formation in human bone marrow cells.Blood. 1969; 34: 380-384
- Testosterone and synthetic androgens improve the in vitro survival of human marrow progenitor cells in serum-free suspension cultures.J Lab Clin Med. 1982; 99: 247-253
- Androgens potentiate the effects of erythropoietin in the treatment of anemia of end-stage renal disease.Am J Kidney Dis. 1991; 17: 29-33
- Effects of testosterone and erythropoietin on erythroid colony formation in human bone marrow cultures.Blood. 1975; 45: 665-670
- Effect of organic and inorganic phosphates on the oxygen equilibrium of human erythrocytes.Arch Biochem Biophys. 1967; 121: 96-102
- The effect of organic phosphates from the human erythrocyte on the allosteric properties of hemoglobin.Biochem Biophys Res Commun. 1967; 26: 162-167
- Androgen-induced increase in red-cell 2,3-diphosphoglycerate.N Engl J Med. 1972; 287: 381-383
- The effects of deoxygenation of adult and fetal hemoglobin on the synthesis of red cell 2,3-diphosphoglycerate and its in vivo consequences.J Clin Invest. 1970; 49: 400-407
- Effect of a single oral dose of oxymetholone on the metabolism of human erythrocytes.Exp Hematol. 1978; 6: 648-654
- The effect of androgen administration on erythrocyte 2,3-diphosphoglycerate level and oxygen affinity in primates.Clin Res. 1972; 20 (Abstract): 487
- Variations of erythrocyte glycolysis following androgens.J Lab Clin Med. 1973; 81: 443-446
- Effect of testosterone propionate on the erythropoietic tissue of three congenital anemias in mice.Biomedicine. 1974; 21: 67-70
- Physiological responses to resistance-exercise in athletes self-administering anabolic steroids.J Sports Med Phys Fitness. 1990; 30: 354-360
- Osteoporosis in hypogonadal men: Role of decreased plasma 1,25-dihydroxyvitamin D, calcium malabsorption, and low bone formation.Bone. 1986; 7: 261-268
- Studies of the mechanism by which androgens enhance mitogenesis and differentiation in bone cells.J Clin Endocrinol Metab. 1990; 71: 1322-1329
- High-affinity androgen binding and androgenic regulation of α1(I)-procollagen and transforming growth factor—β steady state messenger ribonucleic acid levels in human osteoblast-like osteosarcoma cells.Endocrinology. 1991; 128: 2723-2730
- Effects of androgens on parathyroid hormone and interleukin-1—stimulated prostaglandin production in cultured neonatal mouse calvariae.J Bone Miner Res. 1990; 5: 1183-1188
- Identification of androgen receptors in normal human osteoblast-like cells.Proc Natl Acad Sci U S A. 1989; 86: 854-857
- Androgen receptors in osteoblast-like cell lines.Calcif Tissue Int. 1991; 49: 182-187
- Androgens directly stimulate proliferation of bone cells in vitro.Endocrinology. 1989; 124: 1576-1578
- Osteoporosis in men with idiopathic hypogonadotropic hypogonadism.Ann Intern Med. 1987; 106: 354-361
- Bone and mineral metabolism in the androgen-resistant (testicular feminized) male rat.J Bone Miner Res. 1993; 8: 801-809
- Effect of excess endogenous androgens on bone density in young women.J Clin Endocrinol Metab. 1988; 67: 937-943
- Polycystic ovary syndrome, androgen excess, and the impact on bone.Obstet Gynecol Clin North Am. 2001; 28: 135-151
- Relation between bone mass and muscle weight.Lancet. 1970; 1: 391-393
- Direct modulation by androgens of the response of human bone cells (SaOS-2) to human parathyroid hormone (PTH) and PTH-related protein.Endocrinology. 1989; 125: 1789-1794
- Oxymetholone promotes weight gain in patients with advanced human immunodeficiency virus (HIV-1) infection.Br J Nutr. 1996; 75: 129-138
- Ketotifen in HIV-infected patients: Effects on body weight and release of TNF-alpha.Eur J Clin Pharmacol. 1996; 50: 167-170
- Oxandrolone in AIDS-wasting myopathy.AIDS. 1996; 10: 1657-1662
- Safety and efficacy of nandrolone decanoate for treatment of wasting in patients with HIV infection.AIDS. 1996; 10: 745-752
- Resistance exercise and supraphysiologic androgen therapy in eugonadal men with HIV-related weight loss: A randomized controlled trial.JAMA. 1999; 281: 1282-1290
- Testosterone replacement and resistance exercise in HIV-infected men with weight loss and low testosterone levels.JAMA. 2000; 283: 763-770
- Effects of pharmacological doses of nandrolone decanoate and progressive resistance training in immunodeficient patients infected with human immunodeficiency virus.J Clin Endocrinol Metab. 1999; 84: 1268-1276
- Anabolic effects of nandrolone decanoate in patients receiving dialysis: A randomized controlled trial.JAMA. 1999; 281: 1275-1281
- The influence of 6 months of oral anabolic steroids on body mass and respiratory muscles in undernourished COPD patients.Chest. 1998; 114: 19-28
- Physiologic effects of nutritional support and anabolic steroids in patients with chronic obstructive pulmonary disease. A placebo-controlled randomized trial.Am J Respir Crit Care Med. 1995; 152: 1268-1274
- Effect of home total parenteral nutrition on body composition in patients with acquired immunodeficiency syndrome.J Parenter Enter Nutr. 1990; 14: 454-458
- Megestrol acetate in patients with AIDS-related cachexia.Ann Intern Med. 1994; 121: 393-399
- Effect of oxymetholone on left ventricular dimensions in heart failure secondary to idiopathic dilated cardiomyopathy or to mitral or aortic regurgitation.Am J Cardiol. 1999; 83: 123-125
- Comparison of the anabolic effects and complications of human growth hormone and the testosterone analog, oxandrolone, after severe burn injury.Burns. 1999; 25: 215-221
- The anticatabolic and wound healing effect of the testosterone analog oxandrolone after severe burn injury.J Crit Care. 2000; 15: 12-17
- A study of oral nutritional support with oxandrolone in malnourished patients with alcoholic hepatitis: Results of a Department of Veterans Affairs cooperative study.Hepatology. 1993; 17: 564-576
- Protein energy malnutrition in severe alcoholic hepatitis: Diagnosis and response to treatment.J Parenter Enter Nutr. 1995; 19: 258-265
- Growth promotion by oxandrolone in a girl with short stature and early pubertal development treated with growth hormone and gonadotropin-releasing hormone—analogue. A case study.Acta Paediatr. 1995; 84: 1207-1210
- Oxandrolone therapy in constitutionally delayed growth and puberty.Pediatrics. 1995; 96: 1095-1100
- Growth promotion and Turner-specific bone age after therapy with growth hormone and in combination with oxandrolone: When should therapy be started in Turner syndrome?.Horm Res. 1997; 47: 102-109
- Combined therapy with growth hormone and oxandrolone in adolescent girls with Turner syndrome.J Paediatr Child Health. 1993; 29: 40-42
- Testosterone-induced remission in aplastic anemia.Am J Dis Child. 1959; 98: 293-302
- Testosterone-induced remission in aplastic anemia of both acquired and congenital types— further observations in 24 cases.N Engl J Med. 1961; 264: 953-967
- Anemias caused by infection and toxins, idiopathic aplastic anemia and anemia caused by renal disease.Pediatr Clin North Am. 1957; : 469-480
- Oxymetholone therapy in aplastic anemia.Blood. 1968; 32: 83-89
- Anabolic androgenic steroids in the treatment of acquired aplastic anemia.Blood. 1969; 34: 283-300
- Oxymetholone treatment in hypoproliferative anemia. I. Frequency of response.Acta Haematol. 1973; 49: 321-330
- Immunologic mechanisms in aplastic anemia.Am J Pediatr Hematol Oncol. 1980; 2: 232-233
- Do androgens enhance the response to antithymocyte globulin in patients with aplastic anemia? A prospective randomized trial.Blood. 1985; 66: 184-188
- Effect of androgens on the response to antithymocyte globulin in patients with aplastic anemia.Eur J Haematol. 1988; 40: 111-118
- Treatment of aplastic anemia (AA) with antilymphocyte globulin (ALG) and methylprednisolone (MPred) with or without androgens: A randomized trial from the EBMT SAA Working Party.Br J Haematol. 1993; 83: 145-151
- Androgen dependency in acquired aplastic anemia.Am J Med. 1977; 63: 320-324
- Treatment of acquired aplastic anemia with cyclosporine and androgens.in: Shahidi NT Aplastic Anemia and Other Bone Marrow Failure Syndromes. Springer-Verlag, New York1989: 155-165
- Fanconi anemia, dyskeratosis congenita and WT syndrome.Am J Med Genet Suppl. 1987; 3: 263-278
- Constitutional aplastic anemia.in: Bick RL Principles of Hematology: Clinical and Laboratory Practice. C.M. Mosby, Baltimore, Md1993: 485-494
- The bone marrow failure syndromes.in: Nathan DG Orkin SH Hematology of Infancy and Childhood. W.B. Saunders, Philadelphia, Pa1998: 237-372
- Congenital bone marrow failure syndromes: Diagnostic and therapeutic strategies.in: McArthur JR Schechter GP Schrier SL Bajus JL American Society of Hematology Education Program. American Society of Hematology, Washington, DC1998: 384-403
- Oxymetholone treatment in myelofibrosis.Blut. 1978; 37: 19-26
- Oxymetholone treatment for sickle cell anemia.Blood. 1975; 45: 769-777
- Hairy cell leukemia. Durability of response to splenectomy in 26 patients and treatment of relapse with androgens in six patients.Cancer. 1985; 56: 2557-2562
- Aplastic anaemia after exposure to burning oil.Lancet. 1995; 346 (Letter): 183
- Aplastic anemia complicating systemic lupus erythematosus: Response to androgens in two patients.Am J Hematol. 1984; 17: 193-201
- Effect of oxymetholone on human cyclic haematopoiesis.Br J Haematol. 1981; 47: 185-193
- Refractory anaemia (RA) type I FAB treated with oxymetholone (OXY): Long-term results.Br J Haematol. 1993; 85: 235-236
- Abnormal cytogenetic clones in patients with aplastic anemia: Response to immunosuppressive therapy.Br J Haematol. 1999; 104: 271-274
- An eleven-year response of trisomy 8 myelodysplastic syndrome (MDS) to oxymetholone (OXYM).Blood. 1999; 94 (Abstract 4497): 2866
- A 6-month study of low-dose recombinant human erythropoietin alone and in combination with androgens for the treatment of anemia in chronic hemodialysis patients.Am J Kidney Dis. 1997; 30: 495-500
- Anabolic steroids. Review.Curr Opin Clin Nutr Metab Care. 1999; 2: 243-253
- A randomized, controlled trial of treatment of alcoholic hepatitis with parenteral nutrition and oxandrolone. II. Short-term effects on nitrogen metabolism, metabolic balance, and nutrition.Am J Gastroenterol. 1991; 86: 1209-1218
- A randomized, controlled trial of treatment of alcoholic hepatitis with parenteral nutrition and oxandrolone. I. Short-term effects on liver function.Am J Gastroenterol. 1991; 86: 1200-1208
- A biochemical abnormality in hereditary angioneurotic edema: Absence of serum inhibitor of C 1-esterase.Am J Med. 1963; 35: 37-44
- Hereditary and acquired C 1-inhibitor deficiency: Biological and clinical characteristics in 235 patients.Medicine. 1992; 71: 206-215
- Hereditary angioedema: A decade of management with stanozolol.J Allergy Clin Immunol. 1987; 80 ([published correction appears in J Allergy Clin Immunol. 1988; 81:1208]): 855-860
- Long-term treatment of hereditary angioedema with attenuated androgens: Survey of a 13-year experience.J Allergy Clin Immunol. 1991; 87: 768-773
- Clinical and biochemical effects of impeded androgen (oxymetholone) therapy of hereditary angioedema.J Allergy Clin Immunol. 1979; 64: 275-280
- Prophylactic treatment of hereditary angioneurotic edema with anabolic steroids.Tokai J Exp Clin Med. 1980; 5: 59-61
- Long-term therapy of hereditary angioedema (HAE). Preventive management with fluoxymesterone and oxymetholone in severely affected males and females.Johns Hopkins Med J. 1974; 135: 391-398
- Hereditary angioedema.N Engl J Med. 1996; 334 (Editorial): 1666-1667
- Treatment of hereditary protein C deficiency with stanozolol.Thromb Haemost. 1987; 57: 20-24
- Hemostatic effects of stanozolol in elderly medical patients.Thromb Res. 1984; 35: 353-358
- Protein C, an anticoagulant protein increased in healthy volunteers and surgical patients after treatment with stanozolol.Thromb Res. 1984; 33: 297-304
- Stanozolol-induced changes in fibrinolysis and coagulation in healthy adults.Thromb Haemost. 1984; 51: 157-164
- Protein C antigen levels in major abdominal surgery: Relationships to deep vein thrombosis, malignancy and treatment with stanozolol.Thromb Haemost. 1985; 54: 622-625
- A double-blind trial of intramuscular stanozolol in the prevention of postoperative deep vein thrombosis following elective abdominal surgery.Thromb Haemost. 1984; 51: 71-74
- Familial antithrombin III deficiency.Br J Haematol. 1984; 57: 527-537
- Oxymetholone therapy in patients with familial antithrombin III deficiency.Thromb Haemost. 1988; 60: 495-497
- Treatment with stanozolol of type I protein C deficiency in an Italian family.Ric Clin Lab. 1984; 14: 673-680
- Decreased anticoagulant tolerance with oxymetholone.Lancet. 1971; 2: 609-610
- Haemostatic effects of supraphysiological levels of testosterone in normal men.Thromb Haemost. 1995; 74: 693-697
- Decreased anticoagulant tolerance with oxymetholone.Lancet. 1971; 1 (Letter): 1356
- Drug-induced cholestasis.Med Toxicol. 1987; 2: 112-160
- Hepatotoxic effects of the anabolic/androgenic steroids.Semin Liver Dis. 1987; 7: 230-236
- Steroids and other hormones.in: Cameron RG Feuer G de la Iglesia FA Drug-Induced Hepatotoxicity. Springer-Verlag, London1996: 543-579
- Anabolic steroid-induced hepatotoxicity: Is it overstated?.Clin J Sport Med. 1999; 9: 34-39
- Peliosis hepatis. Twelve cases associated with oral androgen therapy.Arch Pathol Lab Med. 1977; 101: 405-410
- Peliosis hepatis associated with androgenic-anabolic steroid therapy. A severe form of hepatic injury.Ann Intern Med. 1974; 81: 610-618
- High incidence of peliosis hepatis in autopsy cases of aplastic anemia with special reference to anabolic steroid therapy.Acta Pathol Jpn. 1984; 34: 1079-1086
- Analysis of 65 Turkish patients with congenital aplastic anemia (Fanconi anemia and non—Fanconi anemia): Hacettepe experience.Clin Genet. 1997; 51: 296-302
- Peliosis hepatis. Report of a case.Am J Clin Pathol. 1952; 22: 569-573
- Reversal of liver damage due to long term methyltestosterone and safety of non-17 α-alkylated androgens.Br Med J. 1985; 291 (Letter): 637
- Fanconi's anemia and hepatic cirrhosis.Am J Med. 1965; 39: 464-475
- Hepatocellular carcinoma associated with anabolic steroid therapy: Report of a case and review of the Japanese literature.J Gastroenterol. 1996; 31: 450-454
- The infectious complications of anabolic-androgenic steroid injection.Int J Sports Med. 1999; 20: 563-566
- Exuberant local tissue reaction to intramuscular injection of nandrolone decanoate (Deca-Durabolin)—a steroid compound in a sesame seed oil base— mimicking soft tissue malignant tumors: A case report and review of the literature.Mil Med. 1992; 157: 670-674
- Use of methyltestosterone to stimulate growth.J Clin Endocrinol. 1956; 16: 241-248
- Study of an anabolic steroid. Certain effects of oxymetholone on small children.Am J Dis Child. 1967; 113: 422-430
- Atherogenic effect of anabolic steroids on serum lipid levels. A literature review.Arch Intern Med. 1991; 151: 1925-1933
- The dyslipoproteinemia of anabolic steroid therapy: Increase in hepatic triglyceride lipase precedes the decrease in high density lipoprotein2 cholesterol.Metabolism. 1987; 36: 949-952
- Contrasting effects of testosterone and stanozolol on serum lipoprotein levels.JAMA. 1989; 261: 1165-1168
- High-density-lipoprotein cholesterol in bodybuilders vs powerlifters. Negative effects of androgen use.JAMA. 1984; 252: 507-513
- Lipoprotein analysis in bodybuilders.Int J Cardiol. 1987; 17: 281-288
- Deleterious effects of anabolic steroids on serum lipoproteins, blood pressure, and liver function in amateur body builders.Int J Sports Med. 1988; 9: 19-23
- Glucose intolerance and insulin resistance in aplastic anemia treated with oxymetholone.J Clin Endocrinol Metab. 1981; 53: 905-908
- Insulin resistance and diminished glucose tolerance in powerlifters ingesting anabolic steroids.J Clin Endocrinol Metab. 1987; 64: 960-963
- Testicular responsiveness to human chorionic gonadotrophin during transient hypogonadotrophic hypogonadism induced by androgenic/anabolic steroids in power athletes.J Steroid Biochem. 1986; 25: 109-112
- Response of serum testosterone and its precursor steroids, SHBG and CBG to anabolic steroid and testosterone self-administration in man.J Steroid Biochem. 1985; 23: 33-38
- Response of serum hormones to androgen administration in power athletes.Med Sci Sports Exerc. 1985; 17: 354-359
- Reversible azoospermia induced by the anabolic steroid 19-nortestosterone.Lancet. 1984; 1: 417-420
Article info
Publication history
Accepted:
June 20,
2001
Identification
Copyright
© 2001 Published by Elsevier Inc.
