Androgen abuse in athletes

Shehzad Basaria
CLINICAL REVIEW:Androgen Abuse in Athletes: Detection and Consequences
J Clin Endocrinol Metab 2010 95: 1533-1543

I liked this article for several reasons:

1. Interesting and timely topic. Not only as it relates to professional sports, but also office consultations from non-professional athletes who have gotten involved in performance enhancement, knowingly or unknowingly through "supplements".

2. Nice mini-review of androgen synthesis and degradation and how this relates to detection

3. Interesting biochemistry for the assays. I love the genetic engineering of yeast to contain androgen receptors which can then activate the firefly gene luciferase to glow in the presence of androgen. See figure 4 for that.

Naturally you can check out the article as a pdf at Google docs through goodreader. By the way I downloaded Apple's Pages and am looking into a keyboard for the iPad now. This article comparing keyboards was helpful.

A Rational Approach to Androgen Therapy for Hypogonadal Men with Prostate Cancer

J Kaufman

Int J Impot Res. 2006;18(1):26-31. ©2006 Nature Publishing Group

Abstract

With earlier detection and improved survival from early stage prostate cancer, it is likely that the numbers of men presenting with hypogonadal symptoms following curative surgery for their cancer will increase. Although testosterone supplementation is effective in improving symptoms of hypogonadism, traditionally such therapy has been contraindicated in patients who have had prostate cancer. This paper reviews the evidence that testosterone therapy can be safely given to selected men with hypogonadism who have had prostate cancer but currently have no evidence of disease by clinical and prostate-specific antigen (PSA) criteria. Such patients should be treated cautiously and followed closely.

Table 2. Recommendations for Testosterone Replacement Therapy After Curative Treatment for Prostate Cancer

• Restrict to symptomatic hypogonadal men with
  

  favorable pretreatment disease and pathologic staging undetectable PSA (or <>

• Discuss pros and cons with patient and get informed consent
  
• Testosterone replacement therapy should be delayed after curative treatment for prostate cancer until undetectable PSA levels are confirmed
  
• Testosterone levels under treatment should be in the low normal range
  
• Monitoring should be performed every 3-6 months for the first year, then yearly thereafter, including the following procedures
  

  PSA Digital rectal exam Serum testosterone