With this weekend’s revelation that baseball superstar Alex “A-Rod” Rodriguez had taken anabolic steroids, the furor over rampant doping in sports continues.



A three-time Most Valuable Player, Rodriguez now joins a pantheon of modern baseball greats tarnished by allegations of steroid use, including homerun “king” Barry Bonds and pitching ace Roger Clemens. But unlike those players -- the latter of whom denied steroid abuse under oath at a congressional hearing last year -- Rodriguez fessed up on ESPN Monday night. He apologized, saying that he was “stupid” for having taken performance-enhancing drugs. Rodriguez says he has stayed clean while wearing the signature pinstriped uniform of the New York Yankees as the team's All-Star third baseman, now entering his sixth season.



According to anonymous sources quoted by Sports Illustrated, Rodriguez allegedly tested positive for testosterone and the anabolic steroid primobolan. But the big league veteran told ESPN’s Peter Gammons that he’s not even sure what banned substances he used during the 2001 to 2003 seasons he spent with the Texas Rangers.



Rodriguez’s name turned up on the list of 104 major league players tagged for using performance-enhancing drugs in 2003 during tests given to gauge the need for mandatory testing to curb use of banned substances. The names have not been publicly released and none of the players were penalized. But the League imposed random drug testing and sanctions in 2004 after 5 percent of the players tested positive for outlawed substances.



During Rodriguez’s confessed era of doping, his homerun average jumped to a super-slugging 52 per season, compared with 36 during his first four seasons in the league and about 42 since. His runs-batted-in (RBI) statistics and total games played also peaked. Even so, his batting average has dipped over his career, from .315 to .305 during his steroid days to .303 over the past five seasons.



In 2003 – reportedly his last year taking anabolic steroids – the League honored him as its MVP. Rodriguez has continued to play Hall of Fame-caliber baseball, and he won two more Most Valuable Players awards in 2005 and 2007.



Anabolic steroids are not the same as prednisone prescribed by physicians for inflammatory and other disorders. Instead, anabolic steroids promote tissue growth, and, in particular, muscle generation – which is why they have become so popular in athletics.



To learn more about the boosting effects of anabolic steroids as well as their potential health risks, ScientificAmerican.com interviewed Jay Hoffman, a professor of health and exercise science at The College of New Jersey in Ewing. Hoffman, who has a PhD in exercise science, used steroids during his football days in the early 1980s, and he recently met Rodriguez.



[An edited transcript of the interview follows.]



Are you surprised by the news that Alex Rodriguez used steroids?

Not at all. I had heard rumors from coaches in the League that he had used them. What I don’t like is Alex coming off [in the ESPN interview] like he didn’t know what substances he took. I’m sure he knew exactly what he put in his body. I was very impressed when I met him in 2006 during a workout at Yankees Stadium, because he asked a lot of really good questions about training. I also admire his work ethic.



Rodriguez allegedly used a steroid called primobolan. What is that drug and how does it work?

It’s an anabolic steroid, also called an androgen, and it is a synthetic form of the male sex hormone testosterone. It increases muscle mass and strength, and also enhances recovery time after a workout. Primobolan is typically injected in the buttocks with a needle. You want to dissipate the steroid through some fatty tissue, because the steroid is fat soluble, and that way you also slow down the metabolism of it for a more sustained dose.





How can you detect primobolan in the body?

Using a urine test, you can take a look at the ratio of testosterone to epitestosterone in the body, which should be one-to-one in a normal male. If someone is taking exogenous (external) testosterone, the ratio will be skewed in favor of testosterone. Also, you can use chromatography, an elaborate lab technique (involving mixture separation) to detect the specific chemical fingerprint for primobolan.



Rodriguez also supposedly tested positive for testosterone. What does that mean?

The hormone is often used as another injectable steroid that together with primobolan dispenses androgenic metabolic properties. When most athletes take anabolic steroids, they use what’s called a “stacking dose,” where they take several steroids to exacerbate the substances’ effects.



What are the short-term benefits of taking these steroids?

You can have a relatively quick enhancement of muscle strength and size, even if you take steroids and don’t lift weights. But the biggest benefit from using anabolic steroids is that they allow an athlete to train harder and have a quicker recovery. An athlete trains on Monday, then he comes back Tuesday and can have just as good a workout through the end of the week. The workouts for most individuals get less intense as the week goes on because they haven’t recovered completely from their earlier workouts.



Why didn’t Rodriguez’s batting average improve during the years he took steroids?

There’s limited research indicating that he could actually enhance his batting average with steroids. A batting average is more indicative of performance ability such as hand-eye coordination. However, research with frogs has shown that anabolic steroids can enhance androgen receptors on nerve endings, so there’s some potential for increased reactions. Hitting in baseball is all about reaction time, whether it’s a curveball or a fastball.



The key benefit with anabolic steroids is that they can help you be consistent over an entire baseball season. That’s the reason you’re seeing those higher statistics for Rodriguez from 2001 to 2003. If you take a look at good power hitters in April and May (early in the baseball season that runs from April to September, excluding the playoffs), their numbers are going to be pretty good. But these guys aren’t able to maintain that in August and September. Take the New York Mets: If that team was on anabolic steroids the way they were in 2000, they probably would have made the playoffs the past two years instead of running out of gas late in the season. It makes a big difference when having that little extra.



Now a guy like A-Rod – he trains really hard. With the steroids, he is maximizing his potential. Would he be a great player without them? Without a doubt. Would he be as consistent? The answer to that is probably no.



What are the side effects of taking steroids?

It’s all dependent upon the concentration, how much you’re taking, how long you’re on them, and also on an individual’s particular reaction. One common side effect is acne on the back – it’s one of the tell-tale signs that someone is using. In addition, you may get elevations in blood pressure and in your lipid (fat) profile – your cholesterol goes up, for example. Over time, the testicles begin to shrink, because the body is no longer producing its own testosterone. There’s a chance that the sperm count will get lower, too. But in some ways, taking steroids is like a second puberty – there is increased hair growth and aggressive behavior. In particular, women who take steroids can get hirsutism, an abnormal growth of body hair, and develop beards.



Steroids can also potentially increase body size, though we haven’t really seen that with Alex. If you look at Barry Bonds, his very noticeable change in head size is actually due to human growth hormone, which is not a steroid and has different mechanisms in the body. Bonds’ increase in hat size is called acromegalia, and it’s not reversible.





How long do the side effects of steroids last?

All of those side effects are reversible within four weeks of cessation, though women tend to stay masculinized after using steroids. And every athlete who has considered juicing (taking steroids) knows that. Athletes generally go on a steroid-taking cycle for six to eight weeks, and then they come off for about two months before going back on. And when they’re off, side effects revert back to normal.



The athletes who run into major health issues are body builders or wrestlers who get paid based on their external appearance. They can develop what’s known as muscle dysmorphia, which is basically reverse anorexia. Like a person who considers himself or herself fat all the time, body builders and wrestlers look in the mirror and see themselves as being small. Those are the athletes who never come off the cycle.



Are there other health risks from taking steroids?

Steroids could be lethal to someone with an underlying mental or cardiovascular disease. Anabolic steroids are like any other medication. If you have hypertension and your doctor prescribes you a certain medication, such as an ACE inhibitor, there may be contraindications for using that particular medication if you have, say, kidney disease. If an athlete is suffering from a mental illness like depression or bipolar disorder – which many steroid-taking high school athletes who commit suicide allegedly suffer from – anabolic steroids are the wrong performance-enhancing drug to use. But when given in a clinical setting, steroids are relatively safe.



How are steroids used in a clinical setting?

By themselves, steroids are a very effective clinical tool for treating muscle-wasting diseases such as cancer, AIDS, and chronic obstructive pulmonary disorders. Sports scientists around the world study changes in athletes’ testosterone and cortisol levels. Cortisol is a catabolic steroid produced by the adrenal glands above the kidneys and it breaks down lean tissue in the absence of carbohydrates needed for energy. It’s also released in times of stress. Through high-intensity training over the course of a baseball season, testosterone levels go down and cortisol levels go up. The athlete becomes testosterone-depleted, or hypogonadal, and fatigue sets in. That phenomenon is known as “overtraining syndrome.”



One way to treat this is to restore testosterone levels using an exogenous (external) source. We do that with men over 50 who have a normal decline in testosterone, though not with the super-pharmacological doses that many athletes use. There’s a lot of talk amongst team physicians about whether it should be permissible to use exogenous testosterone to bring an athlete back up to normal levels. But the issue is not being approached right now, because of the witch hunt that’s going on. There’s such a kneejerk reaction in the sports media about steroids and these things get sensationalized. There’s such a lack of understanding about what steroids do. I think we need to look at this more scientifically.



Rodriguez has won two MVPs since he stopped juicing. Can athletes keep the gains in muscle mass without continuing steroids?

The muscles begin to come down, though there’s still a significantly greater difference in size and strength even eight weeks after you’ve taken the drugs. Again, it all depends on how much you’ve taken and how hard you train. But can you keep gains three years later? No.



So the big question people may be asking is if Alex is taking something else. His homerun numbers have declined, but they’re still pretty damn good. The benefit of the doubt for him, however, has now gone out the window. For example, maybe his [lucrative] contract could allow him to buy a designer steroid that’s undetectable. What the people who are involved in [professional sports drug] testing realize is that most athletes in that community are a few years ahead of the drug testing laboratories. Now is Alex on the cutting edge? It’s possible.



What was your own experience with taking steroids?

I started using anabolic steroids my senior year of college in 1982 at St. Johns (in Queens, N.Y.) which is a small school for football – not like their acclaimed basketball program. I wanted the opportunity to play professional football, and I thought I needed to do something to compete with the athletes coming out of Division I (the top collegiate athletic tier). For me, it was important to be as big as possible. It was my dream. And I was very fortunate to be the first athlete from St. Johns to sign a professional contract with a National Football League (NFL) team, the New York Jets. I did not make it past training camp though, and then I was traded to the New Jersey Generals, then the Tampa Bay Bandits (both part of the now-defunct United States Football League). Then in 1984 I signed on with the Philadelphia Eagles.



I used steroids for those three years, from 1982 to 1984. At the time, steroids were not illegal. I had a prescription for them and bought them at a pharmacy, just like any other medication. Most of the guys in the training camps would use, and so we’d discuss whose room we would inject in that night. At that time in the NFL, it was one of those things you had to do to play in the League, I felt.



Team physicians were not involved, as far as I know, but they monitored our health. I had constant exams to make sure my liver enzymes were functioning properly and my heart was doing well, and that all the blood lipids were fine. I did it in what you could say was the right way. I wasn’t abusing steroids or going to two different physicians to get two different prescriptions to double up on dosages. I was doing it professionally.



Did you experience any side effects?

I had the side effects that you would normally see – the acne, the hypertension – but nothing that was too terrible that I couldn’t deal with. My last season, I took a powerful androgen and it was the first time that I really saw significant changes in my personality. And I felt at that point in my third training camp that those types of changes were not worth it to me, and I stopped using. But the experience did spark a lifelong interest in why steroids are effective and also to take a look at alternatives.



What do you think about alternative strength-promoting supplements?

When I played, they didn’t have the type of supplements that exist today, like creatine (an organic acid that helps supply muscles with energy) and beta-alanine (an amino acid that helps regulate pH in muscles) and some kinds of protein. If they did, I’m sure I would have used those instead of anabolic steroids. But I don’t regret at all what I did, because I did it with care. I knew exactly what I was putting into my body. I knew exactly why I was doing it and I knew the price I was willing to pay for that. I would do it again. There are no long-term effects – I have three healthy, beautiful children. I didn’t grow a third leg or become impotent or any of that BS you see on TV. But there are those athletes who have problems, because they never stop using and they have underlying health issues like mental illness or heart problems. That’s why education becomes so important.



What do you think about the debate over performance-enhancement drugs in sports?

We have to keep in mind that these professional athletes are individuals who are at their physiological edge, or limit. These people understand their bodies so well. They know they need something more. So that’s the importance of trying to get them to understand what they can and cannot do. Unfortunately, for many years, Major League Baseball ignored that and didn’t have the appropriate people in the locker room to help provide that sort of education. So the athlete is left alone, and as a result they go to the gym rat and get the wrong information.