The good, bad and the ugly!

Let’s start with the ugly. 2021 has been a sad year for the professional bodybuilding world. There have been at least 15 deaths in top level professionals, and high-ranking amateurs. Why did this happen, and could it have been prevented?

• Shawn Roden, aka Flexatron, age 46 died unexpectedly on 11/10/21 from a “suspected heart attack.” He won Mr. Olympia at age 43 (oldest bodybuilder to capture the title). According to reports, Roden had suffered a previous heart attack.

• Vic “Mr. Big” Richards, age 56, passed away from heart failure on 11/14/21

• George “Da Bull” Peterson, age 37. He was found dead in hotel room 10/7/21 

• John “Mountain Dog” Meadows, age 49, died on 8/8/21. He had sustained a major heart attack with permanent heart damage 5/2020 but went back to heavy training. According to reports he “suffered a heart attack due to massive blood clots in his coronary arteries”

• Megan Elizabeth, age 28, died 8/25/21. Cause of death is unknown

• Phil Hernon, age 55, died on 8/19/21 due to “sudden decline in health”. He had been on dialysis

• Orlando Galluci, age 38, died on 8/18/21 of a heart attack. Found dead just before competing in 2021 NPC European Championship

• Alena Hatvani, age 46, died 8/15/21. The cause of death is unknown. She was getting her final tan and started to faint before competing in Europa Pro2021

• Sofia Grahm, age 27, died in her sleep on 7/31/21. The cause of death is unknown. She was prepping for a show 

• Salah Hussein, age 39, died of stroke on 7/21/2021 

• Jenny Lynn, age 49, died in her sleep on 7/18,2021

• Melissa Coates, age 50, died on 6/23/21 of unknown cause (8 months prior to her death her leg was amputated “due to blood clots obstructing the blood flow to her lower leg.”

• Andy Haman, Age 55, died on 3/19/21 due to “complications of elbow joint surgery.” Reports read “pulmonary embolism”

• Michael “Big Kentucky” Thier, age 50, died on 2/21/21 of kidney failure

• Richard “Dustin” Cosman, age 39, “passed away in his sleep” on 1/1/21

Death in the line of duty is not new in bodybuilding. The many premature deaths of promising bodybuilders should be a wake-up call to such athletes to be careful. They should be wary of what they consume and generally the kind of lifestyle they lead.

Bodybuilding is indeed a sport. The discipline, focus and sacrifice to succeed in competition is incredible. I should know, because I competed for several years, working my way up the ladder to the Masters National level. I loved it, because it afforded me an opportunity to make a personal goal and to create an action plan to achieve that goal.  Regardless of my placing, I always entered each contest in my best possible condition.

Was it healthy? I can honestly say that is questionable. I mean losing 30 pounds in a span of 12 weeks sounds drastic to me today. Shunning all carbs and fat leaves you with essentially no energy. But to win contests you do what you must do. What I greatly respect is the commitment required. I had and still have that mentality, but I also knew when to draw the line.

What about all these recent bodybuilding deaths. What are the dangers of competitive bodybuilding? Well, it’s not the heavy lifting, vigorous training, or even the diet, despite how drastic that might be. It boils down to misuse of drugs: anabolic steroids, human growth hormone, insulin, and diuretics.

These dangers are not unique to competitors. There are countless athletes and non-athletes alike who have no intention of competing, but who use these drugs to look good, to overcome body dysmorphia, to enhance athletic performance, or simply to achieve that edge. The pity is that such folks often obtain and abuse drugs from unsafe sources and without any medical supervision.

The following are the long-term effects of anabolic steroids on such individuals.

    MOST DAMAGING:

• Kidney problems or failure

• Liver damage and tumors

• Enlarged heart, high blood pressure, and changes in blood cholesterol, all of which can increase the risk of stroke and heart attack, even in young people

• Increased risk of blood clots

Less dangerous but nonetheless other adverse effects include acne, oily skin and scalp, male pattern baldness, insomnia, mood changes, and tendon ruptures.

Heart disease is the most feared risk of prolonged steroid use. The following constitutes the complications that may be encountered:

• Abnormalities in blood lipids (total cholesterol, LDL (lousy cholesterol) and HDL (healthy cholesterol)

• Hypertension

• Coagulation disorders (such as platelet aggregation, leading to blood clots)

• Cardiomyopathy (often a heart that is either thickened, enlarged and often with impaired relaxation, known as diastolic dysfunction)

• Myocardial infarction and fatal arrhythmias that could lead to sudden cardiac death

I have evaluated several top-level pro bodybuilders and fitness competitors in my practice. Because of their awareness of these cardiac and other risks, they have done quite well as a whole. However, most competitors never see a physician.

I have no details as to the medical history on any of the individuals listed above. However, I venture to say that most of these fatalities could have been prevented. Let’s face it; how often do we see heart attacks, strokes, and both heart and kidney failure in the healthy young adult population?

For those who choose to use steroids, I recommend practicing prevention to mitigate the cardiac risks secondary to anabolic steroids.

WHAT ABOUT INSULIN?

Insulin is an anabolic hormone which promotes storage of nutrients such as carbohydrates in the form of glycogen and amino acids for protein synthesis. Therefore, such nutrient storage fuels the muscles and boosts muscle mass

Insulin abuse is the latest deadly trend. Bodybuilders use it -- often in combination with steroids -- to pump their muscles full of staying power. It's estimated that one in four steroid abusers also take insulin.

The insulin helps feed muscles during intense exercise, prevents muscle breakdown, and helps performance. The International Olympic Committee bans insulin. However, it's impossible to detect. Cheaters can take it just before an athletic competition and not get caught.

 Insulin just might boost athletic performance. And it just might kill. Bodybuilders are generally insulin sensitive as it is. By taking exogenous insulin and not knowing how and when to ingest carbs can seriously lower blood sugar. COMA and DEATH can result.

Insulin also promotes fat storage.  As powerful as insulin is, it also has a major flaw. It can build up fat cells and muscle cells in equal measure. If you eat sugary carbs at the same time as you eat fat, your body transports the carbs into the cells right along with the fat.

HUMAN GROWTH HORMONE (HGH)

Combining steroids with HGH is certainly not new. While steroids are best known for increasing muscle mass and strength, HGH, on the other hand, impacts body composition. It directly promotes fat burning. It is involved with the turnover of muscle tissue, which is important for adding lean muscle mass. HGH helps to maintain, build, and repair healthy tissue in the brain and other organs. This hormone can help to speed up healing after an injury and repair muscle tissue after exercise. This helps to build muscle mass, and boost metabolism,

While all this sounds great, there are some major drawbacks:

• Carpal tunnel syndrome.

• Increased insulin resistance.

• Type 2 diabetes.

• Swelling in the arms and legs (edema)

• Joint and muscle pain.

• For men, enlargement of breast tissue (gynecomastia)

• Increased risk of certain cancers.

If you’ve observed top level pro bodybuilders lately, you might notice that their abdomens are grossly distended, despite having ripped abs. This is anything but aesthetically pleasing and is a result of overuse of HGH and insulin. Indeed, the liver and spleen can enlarge as well as the kidneys and loops of bowel. What’s worse is that these changes are generally permanent. Don’t expect internal organs to shrink back to their normal size once HGH is discontinued!

DIURETICS:

Competitive bodybuilders strive for that hard shredded, dry look at contest time. Diuretics are often used to achieve this goal. However, severe dehydration, kidney failure, electrolyte derangements, cardiac arrhythmias and sudden death can result. Talking about death in bodybuilding, most hospitalizations and deaths are, in fact, overwhelmingly due to the use and abuse of diuretic supplements.

NOW THE GOOD!

The focus thus far in this article may seem negative, but being prompted by the recent deaths in bodybuilders, I felt the need to come forward and bring this discussion to light.

But there is mostly good in bodybuilding and strength training. I may be a cardiologist and I do recommend aerobic exercise, but if I only had a few minutes to train, I would favor weight training.

Weight training helps increase your strength while improving the tone and amount of muscle you have. This is vital for long-term health since inactive adults lose anywhere between 3-8% of their muscle mass per decade.

Resistance training for the older adult, age 65-and above has been extensively studied. The health benefits are well known and include the following:

• Increases muscle strength and endurance.

• Increases muscle mass which translates into improvements in functional capacity (combatting sarcopenia or muscle wasting).

• Increases bone density (combatting osteoporosis).

• Increases insulin sensitivity (combatting diabetes and metabolic syndrome).

• Mitigates pain from arthritis.

• Improves sleep.

• Reduces depression.

There are additional cardiac benefits of weight training that are becoming increasingly well appreciated.

In conclusion, weight or resistance training should be a permanent component of your exercise regimen. Each one of us could benefit.

As your own Medical Advocate, choose what’s best for your individual health and wellness. You will never go wrong with strength training.

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this site. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2021