The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.
Designer steroids – over‐the‐counter supplements and their androgenic component: review of an increasing problem
Open accessAbstract
Summary: Colloquially referred to by various misleading monikers (‘pro‐hormones’, ‘natural steroids’, ‘testosterone boosters’, etc.) designer anabolic steroids have been popular now for over a decade as a way to achieve classic anabolic steroid‐like results from products sold in the legal marketplace. Recent evidence suggests that anabolic steroid use may be the most common cause of hypogonadism in men of reproductive age. Despite recent regulatory efforts that have banned specific compounds, many anabolic‐androgenic steroids (AAS) remain available in over‐the‐counter dietary supplements that are legally sold in the United States. Severe side effects including hepatotoxicity, cholestasis, renal failure, hypogonadism, gynecomastia, and infertility have been reported secondary to the use of these products. While some of these side effects may be reversible, more aggressive use may result in more permanent end‐organ damage as has been previously described for the case of aggressive AAS users (Rahnema et al., Fertil Steril, 2014). Designer AAS remain easily available for purchase in over‐the‐counter bodybuilding supplements and these products appear to be increasingly popular, despite the known health risks associated with their use. We conducted a systematic search to identify the designer steroids that are most commonly sold in dietary supplements as of April 2014 and review what is known regarding their potency and toxicity. We propose that the impact of AAS use on the reproductive and hormonal health of men is underestimated in the literature owing to previous studies’ failure to account for designer steroid use. Lastly, we make clinical recommendations to help physicians steer patients away from potentially harmful supplements, and summarize key regulatory obstacles that have allowed potent androgens to remain unregulated in the legal marketplace.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“While short-term use may lead to increased muscle mass, long-term use has been associated with increased risks of hepatic dysfunction, carcinoma, and cardiovascular disease, as well as prolonged testicular suppression and subfertility (33-35).”
From Non-testosterone management of male hypogonadism: an examination of the existing literature (2020) · cites this paper as [35]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Many of these compounds are novel, with no published research on their safety or efficacy and have varying anabolic effects, but may still be associated with dependence, hypertension, polycythemia, liver toxicity, and subfertility (35).”
From Non-testosterone management of male hypogonadism: an examination of the existing literature (2020) · cites this paper as [35]
The cited source says what the claim attributes to it.
In the citing paper
“with one report finding that synthetic oral anabolic-androgenic steroids have been detected in up to 20% of performance-enhancing drugs sold legally over the counter (35,40,41).”
From Non-testosterone management of male hypogonadism: an examination of the existing literature (2020) · cites this paper as [35]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Sagoe, D., Molde, H., Andreassen, C. S., Torsheim, T., & Pallesen, S. (2014) · Annals of Epidemiology · doi:10.1016/j.annepidem.2014.01.009 · Cited by 699
Androgens in Men — Uses and Abuses
Bagatell, C. J., & Bremner, W. J. (1996) · New England Journal of Medicine · doi:10.1056/nejm199603143341107 · Cited by 463
Nutritional supplements cross-contaminated and faked with doping substances
Geyer, H., Parr, M. K., Koehler, K., Mareck, U., Schänzer, W., & Thevis, M. (2008) · Journal of Mass Spectrometry · doi:10.1002/jms.1452 · Cited by 375
Anabolic–androgenic steroid dependence: an emerging disorder
Kanayama, G., Brower, K. J., Wood, R. I., Hudson, J. I., & Pope, H. G. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02734.x · Cited by 308
Anabolic steroid–induced hypogonadism: diagnosis and treatment
Rahnema, C. D., Lipshultz, L. I., Crosnoe-Shipley, L., Kovac, J. R., & Kim, E. D. (2014) · Fertility and Sterility · doi:10.1016/j.fertnstert.2014.02.002 · Cited by 263
Self-citationAnabolic Steroid Induced Hypogonadism in Young Men
Coward, R. M., Rajanahally, S., Kovac, J. R., Smith, R. P., Pastuszak, A. W., & Lipshultz, L. I. (2013) · The Journal of Urology · doi:10.1016/j.juro.2013.06.010 · Cited by 130
Research of stimulants and anabolic steroids in dietary supplements
Baume, N., Mahler, N., Kamber, M., Mangin, P. J., & Saugy, M. (2005) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2005.00442.x · Cited by 127
Over-the-Counter Drug Use in Gymnasiums: An Underrecognized Substance Abuse Problem?
Kanayama, G., Gruber, A. J., Pope, H. G., Borowiecki, J. J., & Hudson, J. I. (2001) · Psychotherapy and Psychosomatics · doi:10.1159/000056238 · Cited by 120
Nutritional supplements: prevalence of use and contamination with doping agents
Thuyne, W. V., Eenoo, P. V., & Delbeke, F. T. (2006) · Nutrition Research Reviews · doi:10.1079/nrr2006122 · Cited by 110
Assessing Supplement Safety — The FDA's Controversial Proposal
Cohen, P. A. (2012) · New England Journal of Medicine · doi:10.1056/nejmp1113325 · Cited by 79
Performance‐Enhancing Drugs on the Web: A Growing Public‐Health Issue
Brennan, B. P., Kanayama, G., & Pope, H. G. (2013) · American Journal on Addictions · doi:10.1111/j.1521-0391.2013.00311.x · Cited by 79
Nieschlag, E., Kumar, N., & Sitruk-Ware, R. L. (2012) · Contraception · doi:10.1016/j.contraception.2012.08.036 · Cited by 60
Anabolic steroids abuse-induced cardiomyopathy and ischaemic stroke in a young male patient
Shamloul, R. M., Aborayah, A. F., Hashad, A. A. A., & Abd-Allah, F. (2014) · BMJ Case Reports · doi:10.1136/bcr-2013-203033 · Cited by 59
Cavalcanti, G. D. A., Leal, F. D., Garrido, B. C., Padilha, M. C., & Neto, F. R. D. A. (2012) · Steroids · doi:10.1016/j.steroids.2012.11.009 · Cited by 43
Diel, P. R., Friedel, A., GEYER, H., Kamber, M., Laudenbach-Leschowsky, U., Schänzer, W., Thevis, M., Vollmer, G., & Zierau, O. (2006) · Toxicology Letters · doi:10.1016/j.toxlet.2006.12.004 · Cited by 42
Kazlauskas, R. (2009) · Handbook of experimental pharmacology · doi:10.1007/978-3-540-79088-4_7 · Cited by 40
Androgens and anabolic agents : chemistry and pharmacology
Vida, J. A. (1969) · Academic Press eBooks · Cited by 40
Metabolic studies with promagnon, methylclostebol and methasterone in the uPA+/+-SCID chimeric mice
Lootens, L., Meuleman, P., Leroux-Roels, G. G., & Eenoo, P. V. (2011) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2011.06.010 · Cited by 37
Nasr, J. Y., & Ahmad, J. (2008) · Digestive Diseases and Sciences · doi:10.1007/s10620-008-0457-x · Cited by 32
Methasteron-Associated Cholestatic Liver Injury: Clinicopathologic Findings in 5 Cases
Shah, N. L., Zacharias, I. A., Khettry, U., Afdhal, N. H., & Gordon, F. D. (2008) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2007.11.010 · Cited by 30
7α-Methyl-18-norsteroids: A new class of potent anabolic and androgenic hormones
Campbell, J. A., Lyster, S. C., Duncan, G. W., & Babcock, J. C. (1963) · Steroids · doi:10.1016/s0039-128x(63)80114-2 · Cited by 24
Severe Hepatotoxicity Caused by a Methasteron-containing Performance-enhancing Supplement
Singh, V., Rudraraju, M., Carey, E. J., Byrne, T., Vargas, H. E., WILLIAMS, J. E. J., Balan, V., Douglas, D. D., & Rakela, J. L. (2009) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e31815a5796 · Cited by 22
Biological Effects of Synthetic Gonanes
Edgren, R. A., Peterson, D. L., JONES, R. C., Nagra, C. L., Smith, H., & HUGHES, G. A. (1966) · Elsevier eBooks · doi:10.1016/b978-1-4831-9825-5.50011-7 · Cited by 22
Geldof, L., Lootens, L., Polet, M., Eichner, D., Campbell, T., Nair, V., Botrè, F., Meuleman, P., Leroux-Roels, G. G., Deventer, K., et al. (2014) · Biomedical Chromatography · doi:10.1002/bmc.3105 · Cited by 17
Okano, M., Sato, M. P., Ikekita, A., & Kageyama, S. (2009) · Drug Testing and Analysis · doi:10.1002/dta.72 · Cited by 17
Totally Synthetic Steroid Hormones. X.1 Some (±)-13β-Ethyl-7α-methylgonane Derivatives
Buzby, G. C., Walk, C. R., & Smith, H. (1966) · Journal of Medicinal Chemistry · doi:10.1021/jm00323a040 · Cited by 12
ANABOLIC-ANDROGENIC ACTIVITY OF A-RING MODIFIED ANDROSTANE DERIVATIVES.
Nutting, E. F., Klimstra, P. D., & Counsell, R. E. (1966) · European Journal of Endocrinology · doi:10.1530/acta.0.0530635 · Cited by 11
Human Mammary Cancer Cell Mutants with Altered Hormone Receptor Activity1
Ueda, H., Hagino, Y., Ono, M., & Kuwano, M. (1986) · The Journal of Biochemistry · doi:10.1093/oxfordjournals.jbchem.a121720 · Cited by 8
ANABOLIC-ANDROGENIC ACTIVITY OF A-RING MODIFIED ANDROSTANE DERIVATIVES.
Nutting, E. F., Klimstra, P. D., & Counsell, R. E. (1966) · European Journal of Endocrinology · doi:10.1530/acta.0.0530627 · Cited by 6
[Biological activity of dimethazine in the protein anabolic sense].
Matscher, R., LUPO, C., & Ruggieri, P. (1962) · PubMed · Cited by 2
Kurachi, K., Aono, T., Tomoyama, J., Matsumoto, K., & Nakasima, A. (1975) · PubMed · Cited by 2
[A case of advanced breast cancer successfully treated with combined tamoxifen and epitiostanol].
Konishi, Y., Morimoto, T., Komaki, K., Yamakawa, T., Mituyama, N., Tanaka, T., Oomine, Y., & Monden, Y. (1988) · PubMed · Cited by 1
FDA Warns of Illegal Steroids Sold as Dietary Supplements
WACHTER, K. (2006) · Internal Medicine News · doi:10.1016/s1097-8690(06)73429-1 · Cited by 1
[A new steroid having proteo-anabolic action: dimethazine].
RUGGIERI, P. D., Matscher, R., Gandolfi, C. A., Chiaramonti, D., LUPO, C., PIETRA, E., & Cavalli, R. D. C. (1963) · PubMed · Cited by 1
Cited by
Sorted by citations
Martin, K. A., Chang, R. J., Ehrmann, D. A., Ibáñez, L., Løbo, R. A., Rosenfield, R. L., Shapiro, J., Montori, V. M., & Swiglo, B. A. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2437 · Cited by 511
Martin, K. A., Anderson, R. R., Chang, R. J., Ehrmann, D. A., Lobo, R. A., Murad, M. H., Pugeat, M. M., & Rosenfield, R. L. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-00241 · Cited by 339
Designer drugs: mechanism of action and adverse effects
Luethi, D., & Liechti, M. E. (2020) · Archives of Toxicology · doi:10.1007/s00204-020-02693-7 · Cited by 262
Nieschlag, E., & Vorona, E. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0080 · Cited by 237
Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review
Albano, G. D., Amico, F., Cocimano, G., Liberto, A., Maglietta, F., Esposito, M., Rosi, G. L., Di Nunno, N., Salerno, M., & Montana, A. (2021) · Healthcare · doi:10.3390/healthcare9010097 · Cited by 200
Metadata
- Authors
- Rahnema, C. D., Crosnoe, L. E., & Kim, E. D.
- Affiliations
- University of Tennessee at Knoxville (US)
- Division of Urology Department of Surgery University of Tennessee Graduate School of Medicine Knoxville TN USA
- Corresponding author
- Kim, E. D.
- ORCID
- Kim, E. D.
- Venue
- Andrology
- Publisher
- Wiley
- Published
- 2015-02-13
- Volume
- 3
- Issue
- 2
- Pages
- 150-155
- ISSN
- 2047-2919 (ISSN-L)
- 2047-2927
- OpenAlex
- W2021273454
- Cited by
- 101
- References
- 36
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 10 · 2023: 11 · 2022: 13 · 2021: 12 · 2020: 8 · 2019: 8 · 2018: 10 · 2017: 9 · 2016: 10 · 2015: 1
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Andrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Social Sciences › Sociology and Political Science › Doping in Sports
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Pharmacological Effects and Assays
- Keywords
- over-the-counter dietary supplements, prohormone, androgenic compounds, hypogonadism, hepatotoxicity, cholestasis, gynecomastia, infertility, reproductive health, supplement regulation, bodybuilding supplements
- MeSH terms
- Androgens, Nonprescription Drugs, Female, Humans, Male, Designer Drugs, Anabolic Agents
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
