In the past couple years, we lost many big name bodybuilders far before their time.
B1: Dorian Yates,
“I got a list of 50…”
That’s Dorian Yates, 6-time Mr. Olympia and with his help, along with the help of various
Bodybuilding influencers we’re going to talk about why Bodybuilders are dying. While researching for
this topic I came across a video by “Zem Fitness” honouring all the recent Bodybuilders who lost
their lives, and as I watch the faces flash on the screen I feel something very profound.
B2.1 & B2.2: Fallen bodybuilders [dad film your reaction to these montages].
These people died pursuing their passion and I’m glad they were able to choose to live their
lives in the way that they wanted, but I am also saddened by their ages and the causes of death–
the greatest evident theme is that of catastrophic heart problems (heart attack, cardiac arrest
and pulmonary embolism), with issues surrounding brain (stroke and seizure), organ failure,
mental health, and chronic injury appearing as well to a lesser degree.
B3: “We put our bodies through hell…”
And for every famous bodybuilder who passes away, there are many amateur bodybuilders and
fitness enthusiasts who run similar risks as they push their bodies to the extreme–
B4: “The number of bodybuilders… half the membership is using gear…”
And before we dig into the specific health risks, we should consider the
more diffuse social factors contributing to early bodybuilder death. In a clip from a recent video,
Minus The Gym points out the prevalence of shredded male bodies glorified in the media:
B5: “Men are being manipulated now to think…”
Looking good can be quite literally a career– and by most people’s accounts, a desirable one
at that. This can drive an industry based on that trait into overdrive. So if the job of
the bodybuilder is to attain a peak physical condition in a world where physical prominence
is rewarded publicly, several things are bound to happen. As Dave Pulcinella from Pulse Fitness and
Bodybuilding already pointed out, more people are eager to join the bodybuilding community. As more
people join, and competition becomes more intense, bodybuilders and their coaches will begin to
push themselves harder and harder to attain more compelling results, making greater sacrifices to
their health in the process. It’s a slippery slope. Dave, care to say a few more words?
B6: Isn’t bodybuilding supposed to be about health and fitness.
He goes on to speak to bodybuilding as an extreme sport and well… that’s what it is.
B7: Extreme sport “... It’s about winning!”
His comparison to skiing and football are striking. Like those dangerous sports–
bodybuilding is about winning. Not health or longevity. But in bodybuilding – perhaps more
so than other sports – it just so happens that the tools (chemicals, substances, habits and
workouts) that are prevalent in the winners circle put very extreme stress on the body.
I think there exists a subconscious misconception about the sport which exists misleadingly in the
realm of “health and fitness” – that these people who look like they are in peak physical condition
when compared to the average individual, are healthier. Sure, lifting weights and
building muscle mass can contribute to health and longevity… but when taken to the extreme?
Not so much. In fact: optimal physical condition has less to do with outward appearance than we may
initially believe. Optimal physical condition is the state that allows you to live within
an environment with a high level of function, comfort, and efficiency while at the same time
minimizing the level of pain and avoiding injury. Optimal physical condition improves
function and prolongs life, and prepares you to be able to adapt to a wide variety of conditions and
tasks. Optimal physical condition is more than maximal strength or maximal hypertrophy. It is
also about flexibility, mobility, cardiovascular endurance, proprioception, and balance.
Now I do not intend to undermine the work ethic and knowledge it takes to excel in bodybuilding.
It seems to me that bodybuilders are often very knowledgeable about their craft,
techniques and the human body– especially the metrics pertaining
to health as they manipulate them to hone their physique.
But when the contemporary judging criteria rewards people who look like this:
Ironically, I pulled those photos from Men’s Health magazine article…
Here Is Every Winner of the Mr. Olympia Competition Since 1965.
And the article below told me how to get 6 pack abs in a couple weeks.
Is bodybuilding still popular in 2020? - Quora
You hear what me interns? This is bigger than just steroids. Bodybuilding
is a stage set for extreme sacrifice. Dorian, have you got anything to add?
B8: “Keep pushing the envelope” It is no secret that performance
enhancing drugs have an adverse effect on the heart. And [whispering] if you want to compete
at the highest level, you’ll need to take PEDs. Who am I kidding, it’s no secret that everyone in
the coveted Mr. Olympia lineup is doing just that. Look at the three finalists from 2021…
B9: Olympia lineup
A link between Anabolic-Androgenic Steroid use and abuse and cardiomyopathy – an umbrella term
that refers to any disorder that affects the heart muscle – has been documented.
B10: how much can i push without killing myself.
Steroids have been shown to impair left ventricular function, which connects nearly
all organ systems through its function to pump oxygenated blood to the body. Due to unfavourable
enlargement and thickening of the left ventricle, which loses its diastolic properties with the
mass increase. This enlargement of the left ventricle is known as hypertrophic
cardiomyopathy. While the cardiac muscle increases in strength with the anabolic steroid use,
it also becomes less able to relax and fill completely in between beats,
leaving it less able to supply oxygenated blood to the body AND itself.
Steroids use has also been linked to dilated cardiomyopathy wherein the cavity of the heart
is enlarged and stretched, compromising the heart's ability to pump normally and
relax appropriately. As a result the supply of oxygenated blood is reduced both to the heart
and from the heart to the arteries. Here the heart is stretched out by the constant high
pressure in the arterial system. It becomes big and floppy, and inefficient at squeezing.
Once again, it has difficulty supplying oxygenated blood to the body and itself.
The coronary arteries are also at risk of narrowing due to steroid use. The heart is
a muscle, similar to other muscles in the body. It receives oxygenated blood through the coronary
arteries– thus it is provided with the fuel that powers its contractions. As the heart activity
increases in conjunction with an increase in overall activity, the demand for oxygenated blood
likewise increases. Normally, the coronary arteries would expand in response, to allow
more oxygenated blood to be delivered to the cardiac muscles. However, if the
coronary arteries are narrowed then less blood is available even when they are temporarily expanded.
High intensity activity can lead to a situation where more oxygen is required by a heart that
is beating faster and working harder, but the cardiac vessels are unable to expand enough
Anabolic-androgenic steroids (AAS) are also associated with atherosclerotic plaque
which further compromises heart pumping. The plaque may partially, or fully occlude one or
more of the coronary arteries, resulting in less, or in some cases, no blood flow – rendering the
heart unable to meet the increased demand of the cardiac muscles. Can you say heart attack…?
Sudden cardiac arrest
attributed to hypertrophic cardiomyopathy by use of anabolic steroids. Case report
Steroid-induced cardiomyopathy | The Medical Journal of Australia.
If the cardiac muscles cannot be supplied with oxygenated blood, their cells die in whatever
distribution is supplied by the coronary arteries unable to meet the required demand.
If enough cells die, the heart is rendered unable to function properly and a heart attack, cardiac
arrest, or non-productive cardiac arrhythmia may occur. I’ve said it before but let me reiterate:
none of these are compatible with life and in the event that life-sustaining treatment is
not immediately available, you will die.
LINKS: Anabolic-Androgenic Steroids May Damage the Heart and Arteries
| NIDA Archives & Reversible anabolic androgenic steroid-induced cardiomyopathy.
Worth noting, the terms heart attack and cardiac arrest are often used interchangeably,
but they are not the same thing. As you might expect, Heart.org has the answers we seek:
“A heart attack occurs when a blocked artery prevents oxygen-rich blood from
reaching a section of the heart. If the blocked artery is not reopened quickly,
the part of the heart normally nourished by that artery begins to die.”
Alternatively, “cardiac arrest is triggered by an electrical malfunction in the heart that causes an
irregular heartbeat (arrhythmia). With its pumping action disrupted, the heart cannot pump blood to
the brain, lungs and other organs. Seconds later, a person loses consciousness and has no pulse.”
High blood pressure has been reported in some cases of anabolic steroid
use which further increases the risk of cardiovascular disease.
We’re just getting started really…
Several case reports associate anabolic steroid use with arterial thrombosis and pulmonary
embolisms, which is a blood clot that blocks the vessels going from the heart to the lungs. A study
from Medical Hypotheses reports that “there exists no direct evidence that androgens are thrombogenic
in humans. However, indirect experimental data suggests that androgens affect platelet
aggregation, coagulation proteins and the vascular system in ways that facilitate thrombosis.” This
means that through indirect influence, anabolic steroids may increase blood clotting– and at some
level the likelihood of clotting related injury such as thrombosis. Needless to say, a pulmonary
embolism can cause a lack of blood flow that leads to lung tissue damage and a particularly large PE
or many clots, can quickly cause serious life-threatening problems and, even death.
Anabolic/androgenic steroid abuse and thrombosis: is there a connection?
Pulmonary Embolism in Bodybuilder Case Study
B10: “upper levels… and then i win”
Many other organs in the body suffer adverse effects due to steroid usage.
One of the liver’s roles is to metabolise drugs into forms that are easier to use for the rest
of the body or that are nontoxic– and most metabolism of anabolic steroids occurs there,
leaving it prone to damage. These compounds are capable of causing cholestatic liver injury (a
subtype of liver injury that is characterised by predominant elevations of alkaline phosphatase
and bilirubin). and long term use of androgens is associated with development of liver tumours
including hepatocellular carcinoma, hepatic adenoma and vascular changes (peliosis hepatis).
Androgenic Steroids - LiverTox - NCBI Bookshelf
Likewise anabolic-androgenic steroids can affect the kidney in different aspects.
The kidney’s main job is to cleanse the blood of toxins and transform the waste into urine.
Researchers propose that extreme increases in muscle mass require the kidneys to
increase their filtration rate, placing harmful levels of stress on these organs. Thus steroids
can induce or aggravate acute kidney injury, chronic kidney disease, and glomerular toxicity.
In a case study performed on 10 bodybuilders who use steroids, Kidney tests revealed that
nine of the ten bodybuilders developed a condition called focal segmental
glomerulosclerosis, a type of scarring within the kidneys. This disease typically occurs
when the kidneys are overworked. The kidney damage in the bodybuilders has similarities to
that seen in morbidly obese patients, but appears to be even more severe.
The potential effects of anabolic-androgenic steroids and growth hormone as commonly used
sport supplements on the kidney: a systematic review | BMC Nephrology
As we have already seen, the increased size
puts many aspects of a bodybuilder's internal physiology into overdrive,
requiring many of their organs to work harder to meet the demands of their increased muscle mass.
Other aspects of their health may suffer due to stressors associated with bodybuilding (and its
PED traditions), but arthritic joints for example don’t pose a direct threat to your mortality.
The risks associated with steroids are well documented as most bodybuilders are aware–
B11: Larry Wheels 1, “and I have been abusing them for about 10 years…”
Larry goes on to suggest that anyone taking PEDs should get their biomarkers checked– especially
those pertaining to heart health as heart failure poses the greatest threat to their mortality.
B12: Larry Wheels 2, “don’t wait until we have symptoms…”
I agree with that sentiment. What is the point of winning if you don’t survive? Still– athletes
are willing to do whatever it takes to put on more size and create more impressive physiques,
experimenting with stronger drugs and combinations, taking more of them:
B13: “I’m told… more than I took for Mr Olympia.”
The problems created by steroid abuse are exacerbated by other
demands that a bodybuilder places upon themselves…
Consider intense dehydration and the use of diuretics during the cutting phase before a meet.
Sure, if you carry less water weight into competition– your muscles will look more
defined, but diuretics may cause electrolyte imbalance by causing negative sodium and fluid
balance inside the body. Unfortunately these electrolytes– such as potassium,
sodium, calcium and magnesium — help trigger and send electrical impulses
in the heart. And the imbalance can interfere with heart signalling and lead to irregular
heartbeats. And we don’t want anything else interfering with the heart, or its rhythm–
Some people have been known to use insulin as well which is actually considered an anabolic
hormone as it promotes nutrients storage and helps prevent cell breakdown. While
insulin alone may not have a potent effect on muscle protein synthesis,
it may have an enhanced effect when paired with anabolic steroids or growth hormone.These factors
lend well to bodybuilding– the main potential complication of using insulin is experiencing
low blood sugar, also known as hypoglycemia. This is a big concern, considering symptoms
of low blood sugar include nervousness, dizziness, trembling, sweating, hunger,
weakness, and palpitations. Severe cases may lead to seizures, loss of consciousness and even death.
B14: ticking time bomb
This coming from the 6-time Mr. Olympia. I mean… Testosterone, Winstrol,
Trenbolone, Diuretics, Insulin sounds like an impressive sandwich. Who am I kidding–
I am uneducated in the art of steroid stacking, so I took a trip over to reddit to read up on
some athletes' best cycles. But that is a can of worms I just don’t want to get into… This
is complicated stuff and each compound reacts differently with each individual.
B15: [Compounds] Your Best Cycle : r/steroids
If you do plan to get into the bodybuilding business.
Proceed with caution! As a doctor my job is to keep you healthy for as long as possible, and it
saddens me to see people pass before their time. I’d like to extend my condolences to the families
of everyone who has lost someone to this sport. And I’ll see you all soon with another video.
As always, that’s been a word from Dr. Chris,
not your every day ortho, where we see one do one and teach one.
Outro