Evidence of hyperhomocysteinaemia following long term anabolic androgenic steroid (AAS) use

Aim
To examine the effects of long term (>20 years) administration of anabolic androgenic steroids (AAS) on plasma homocysteine (HCY), vitamin B12, and folate concentrations.

Methods
Subjects (n = 40) were divided into four distinct groups: AAS users (n = 10) who were still using at time of testing (SU), a group of AAS users (n = 10) who had been abstinent from AAS administration
for more than three months before examination (SA), bodybuilding controls (n = 10) who did not use any pharmacological ergogenic aids (BC), and sedentary male controls (SC) (n = 10).

Results
HCY was significantly higher in SU compared with BC, SC (p<0.01), and SA (p<0.05). Fat free mass was significantly higher in both groups of AAS users (p<0.01). Daily energy intake and daily protein intake (%) were significantly higher (p<0.05) in SU and SA
compared with BC and SC groups, but was unlikely to be responsible for the observed HCY increases. Haematology was unremarkable between the groups except for the packed cell volume which was significantly higher (p<0.01) in the SU group. A significant inverse relation was observed between sex hormone binding globulin and HCY, particularly in the SU group (r = −0.828; p<0.01), indicating a possible
influence of the sex hormones in determining HCY levels.

Conclusion
With the mounting evidence linking the capacity for
AAS to adversely affect a number of clotting factors, the significantly higher levels of HCY and packed cell volume observed in the SU group suggests that long term AAS users are at increased risk of developing future thromboembolytic events.