Prohormones such as DHEA (dehydroepiandrosterone) and androstenedione reached a peak in popularity during the 1990s as their use by high-profile athletes became common knowledge. In a survey conducted by the Department of Health and Human Services in 2002, an estimated 2% to 2.5% of high school students reported using androstenedione.81 Unfortunately, the perceived success of athletes known to use these products has been interpreted by many youths as a cause-and-effect relationship, when medical evidence runs to the contrary.
In his review of the literature, Ahrendt82 found no published studies that reported ergogenic benefits of DHEA use. In one study, DHEA did increase androgen levels, but there were no increases in strength or lean body mass measurements following resistance training.83 Similarly, Tokish et al72 reviewed the literature and found no evidence of ergogenic benefits of androstenedione. In fact, there may be an increased risk of cardiovascular disease with androstenedione use due to decreased high-density lipoprotein levels. Other studies have demonstrated no effect of androstenedione on testosterone levels while increasing estrogen levels in males.84,85 Conversely, androstene-dione has also been linked to elevating testosterone levels in females,86 suggesting a gender-specific metabolism of these products. Based on the clear estrogenic and androgenic effects of these products in the absence of any reasonable benefits, the U.S. Food and Drug Administration in 2004 issued a summary of the negative effects of androstenedione and a warning to its manufacturers that such products are in violation of the 1994 Dietary Supplement Health and Education Act, and that their production and marketing should cease.81,87
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