CHEATING TO WIN

HISTORY / BODY

From Medicine to Muscle: The Rise of Anabolic Steroids

Six people pose beneath a York Barbell Club sign in a black-and-white photograph.

FIG. 1 · 1949 · CC BY-SA 4.0

York Barbell Club in Caracas, 1949, as identified by the source. This earlier Venezuelan club photograph provides context for the York name; it does not show the three US lifters in Todd’s account or establish drug use by anyone pictured. Credit: Nicolás Gavidia; scan and small restoration by Wilfredor, CC BY-SA 4.0. Reproduced without additional edits.

Safety at a Glance

Anabolic-androgenic steroids

U.S. federal legal / access status

  • Testosterone products (e.g. DEPO-Testosterone): prescription only · Schedule III [REG-S02; LABEL-S01; LAW-S02]
  • Medical approval does not cover athletic enhancement [LABEL-S01]
Main risk
Nonmedical use: heart attack, stroke, blood clots, liver damage, psychiatric changes [HEALTH-S01; LABEL-S01]
Critical warning
Withdrawal can involve severe depression; consult a health professional promptly [HEALTH-S01; REG-S03]
Human lethal dose
No reliable human lethal threshold established in the reviewed sources; fatal complications can develop over time [LABEL-S01; HEALTH-S01]

Suspected overdose or poisoning

Poison Control: 1-800-222-1222

Call 911

Call 911

Collapse, seizure, breathing trouble, or cannot be awakened

Urgent assessment: chest pain, sudden shortness of breath, painful swollen leg, yellow skin or eyes, brown urine, or suicidal thoughts [HELP-N01; LABEL-S01; REG-S03; HEALTH-S01]

Medical treatment ≠ nonmedical enhancement. Methandienone FDA status unverified. Full safety details below.

United States emergency guidance · checked Oct 31, 2026 · not medical advice

"The most important article I ever wrote"

In November 1961, the American weightlifting promoter Bob Hoffman published an article in his magazine Strength and Health under the title "The Most Important Article I Ever Wrote" HIST-S01. According to Terry Todd, writing in the Journal of Sport History, the article promoted a little-known training method called isometric contraction: pushing or pulling against an immovable object. Hoffman credited it, Todd writes, for the startling progress of three lifters from his York Barbell Club HIST-S01.

What the article left out, in Todd's account, was that the three men were also taking Dianabol, a new pill HIST-S01. Readers who tried isometrics generally failed to make the same progress, Todd writes, which only fed speculation. Eventually the secret leaked HIST-S01.

Todd published that history in 1987, drawing partly on interviews he conducted in 1983 with the physician involved and two lifters HIST-S01. It is a retrospective account, not a contemporary record, and this article has not read the 1961 magazine itself. But it captures a problem that runs through the whole history of anabolic steroids. When an athlete suddenly gets stronger, what caused it? The training? The drug? Belief? Some mix of all three? And who gets to tell the story?

This is the story of how hormones developed for medicine became tools for strength, physique and competition. It is also a story about four questions that are easy to confuse. Does a drug work? Is it medically appropriate? Is it fair in sport? Is it legal?

What "anabolic" means

Our article on 1935 covers how chemists isolated and made testosterone, the main male sex hormone. Anabolic steroids are synthetic substances similar to it HEALTH-S01.

They have two broad kinds of effect. Anabolic effects build tissue, including skeletal muscle. Androgenic effects drive male sexual characteristics, such as body hair and a deeper voice, in both men and women HEALTH-S01. That is why scientists use the longer name anabolic-androgenic steroids. The two effects travel together. No drug in this story is a muscle-only switch.

They work mainly through the androgen receptor, a protein inside cells. When a steroid binds to it, the receptor helps switch particular genes on or off HEALTH-S01; LABEL-S01.

The body also has a thermostat. When hormones arrive from outside, the pituitary gland notices and cuts the signals that tell the testicles to make their own testosterone. At large doses, the signals that support sperm production can be suppressed too LABEL-S01. This feedback suppression explains several of the risks discussed below.

One more distinction matters. Corticosteroids are also steroids, but they are a different family of medicines. US law expressly excludes them, along with oestrogens and progestins, from its definition of an anabolic steroid LAW-S01.

From Vienna to York

Todd traces the American strength-sport story to the 1954 World Weightlifting Championships in Vienna. Hoffman was the US team coach. The team physician was Dr. John Ziegler HIST-S01. In the account Todd assembled, Ziegler suspected the Soviet lifters were using testosterone and later said a Soviet team physician confirmed it HIST-S01.

That is Ziegler's recollection, recorded decades later. It is not a verified transcript, and it does not prove that anyone at Vienna was the first person to use hormones for sport.

Back in the United States, Todd writes, Ziegler obtained testosterone and tried it on himself, on Hoffman and on several East Coast lifters HIST-S01. He was worried about side effects, including prostate problems and increased libido. So he wanted a drug with testosterone's muscle-building, "anabolic" effects without its "androgenic" ones HIST-S01.

In 1958, the pharmaceutical company Ciba released Dianabol, a drug in the anabolic-androgenic family HIST-S01. It was not intended for athletes. Todd says it was developed for burn patients and certain post-operative and elderly patients HIST-S01. Those were its historical uses, described by a sport historian. They are not current FDA-approved uses, and this article has not verified whether any methandienone product is approved in the US today.

Ziegler, according to Todd, had other plans. With Hoffman's approval, he persuaded three York lifters to take Dianabol and to train secretly with isometrics HIST-S01. Todd credits Ziegler with a critical role in spreading anabolic drugs in sport. Todd's account does not show that Ziegler invented the idea, or that he alone was responsible.

How it spread

Todd is careful about causes. He describes four things that happened to exist at the same moment:

Together, he argues, these factors raised expectations and intensified competition among strength athletes. He states plainly that no one of the four was individually responsible HIST-S01.

That caution matters, because the York story mixes two things a scientist would want to separate. The lifters changed their training and took a drug. Their gains, however striking, were anecdotes, not a controlled test.

Medicine, meanwhile, was sceptical. Todd writes that prevailing medical opinion in the 1960s held that these hormones gave no athletic advantage. He cites a UCLA study that did not support muscle or strength benefits from the therapeutic doses it examined HIST-S01. In his account, medical opinion did not shift significantly until the early 1980s.

Todd also records a suspicion that persisted among athletes: that doctors understated the gains in the hope of discouraging use. In his telling, that backfired, encouraging athletes to seek drugs and advice outside medical channels HIST-S01. That is a claim about athletes' perceptions, which Todd attributes to them, not a proven motive of the medical profession.

A state programme

Not all doping was the work of individual athletes and coaches. After East Germany collapsed in 1990, some classified documents survived. In 1997 Werner Franke and Brigitte Berendonk analysed them in the journal Clinical Chemistry HIST-S02.

According to their abstract, the documents describe a government-promoted programme from 1966 onwards. Hundreds of physicians and scientists performed doping research and gave athletes prescription drugs and unapproved experimental preparations HIST-S02. Several thousand athletes a year were treated with androgens, including minors of both sexes. The documents placed special emphasis on giving androgens to women and adolescent girls, because this proved particularly effective for performance HIST-S02. Damaging side effects were recorded, and some required surgery or medical treatment. Scientists also helped develop ways of evading doping controls HIST-S02.

We have read the abstract, not the full paper or the archives it analyses. Those findings concern one country's documented programme. They are not evidence about any individual athlete who is not named in that research, or about every athlete from Eastern Europe.

Testing arrives

Detection was the practical obstacle. Todd writes that one reason the International Olympic Committee did not list anabolic steroids when it banned certain drugs in 1967 was that there was then no way to test for them HIST-S01. In 1973, two reports in the British Journal of Sports Medicine proposed methods: one using radioimmunoassay, the other gas chromatography and mass spectrometry. The IOC adopted both HIST-S01.

The first Olympic use of the new test, Todd writes, came at the 1976 Montreal Games, where eight of 275 athletes tested were positive for anabolic steroids HIST-S01. He warns against reading that low figure as a clean bill of health. In his account, athletes switched to a drug the test could not yet catch: testosterone itself, the hormone Ziegler had set aside in favour of Dianabol HIST-S01.

The story had come full circle, back to the hormone isolated in 1935.

Weightlifting medal ceremony in an indoor Olympic arena, with a Norwegian flag in the foreground.

FIG. 2 · 1972-09-02 · CC BY-SA 4.0

Light-heavyweight weightlifting medal ceremony, Munich Olympics, September 2, 1972. This is four years before the Montreal testing discussed here; the photograph provides competition context and makes no claim about any athlete’s drug use. Credit: Van.ike, CC BY-SA 4.0. Reproduced without additional edits.

Evidence catches up

Athlete testimony and controlled research did not always tell the same story. In 1996, the New England Journal of Medicine published a randomised, placebo-controlled trial by Shalender Bhasin and colleagues TRIAL-S01.

According to its abstract, 43 healthy men were randomly assigned to one of four groups:

The study ran for 10 weeks, and the testosterone exposure was supraphysiologic—above the normal physiological range TRIAL-S01.

Men given testosterone gained more muscle size and strength than men given placebo, even without exercise. For the testosterone-plus-training group, the abstract reports larger gains in fat-free mass and muscle size than in either no-exercise group, and larger strength gains than in those groups TRIAL-S01. The abstract also reports that mood and behaviour did not change in any group TRIAL-S01.

That was an important result. It showed, under controlled conditions, measured changes the earlier sceptical studies had not found. But it has clear limits. It was ten weeks long, involved 43 men, and tested one testosterone preparation. It cannot establish long-term safety, the effects of other steroids or combinations, or what happens to women, teenagers, or people buying products of unknown content. A mood finding in one short, supervised trial is not evidence about unsupervised use. We have read the abstract only.

Sport rules and criminal law are different things

Sport bans and drug laws developed separately, and they still answer different questions.

Sport rules govern eligibility and prohibited conduct. US controlled-substance law separately regulates possession and distribution. Public Law 101-647, enacted on November 29, 1990, included as its Title XIX the Anabolic Steroids Control Act of 1990. It added anabolic steroids to Schedule III of the Controlled Substances Act and defined the term, listing testosterone and methandienone among others LAW-S01. The schedule change did not take effect on the day of signing. The Act says it took effect 90 days after enactment LAW-S01.

Today's federal regulation still places anabolic steroids in Schedule III. It names testosterone and methandienone, among many others, unless a substance is specifically excepted or listed elsewhere LAW-S02. Scheduling is not the same as FDA approval. It also does not settle state law or sport eligibility.

FDA approval is a third, separate question: whether a specific product is approved for a specific medical use. Testosterone products are approved only for men who lack or have low testosterone in conjunction with an associated medical condition REG-S02. The label for one widely used injection says plainly that the drug has not been shown to be safe and effective for enhancing athletic performance LABEL-S01.

So a prescription can be lawful and medically appropriate while use of the same hormone in competition breaks sport rules. Buying the same hormone without a prescription can be both illegal and unsafe.

A bottle labeled Dianabol Methandrostenolone, photographed with two white tablets in front.

FIG. 3 · 2014-07-10 · CC BY-SA 4.0

A bottle labeled Dianabol, photographed July 10, 2014. This is a later product photograph, not Ciba’s 1958 packaging. The photograph does not verify contents, authenticity, FDA approval or safety, and is not a product recommendation. Credit: Nuklear, CC BY-SA 4.0. Reproduced without additional edits.

Beyond the podium

Steroids are popularly associated with elite athletes. But a 2018 report from the National Institute on Drug Abuse (NIDA) states that since the 1980s, use by male non-athlete weightlifters has exceeded use by competitive athletes HEALTH-S01. NIDA describes most users as men trying to improve their appearance. It links steroid use closely to muscle dysmorphia, a body-image disorder in which men see themselves as small and weak even when they are large and muscular HEALTH-S01.

NIDA's 2018 account is dated, and this article does not offer a current estimate of how many people use steroids.

The marketplace has also blurred categories. FDA warns that some bodybuilding products sold online and in shops as "dietary supplements" illegally contain steroids or steroid-like substances. FDA links these to serious liver injury and other serious reactions REG-S03. That does not mean every supplement contains steroids. It does mean a label is not proof of contents.

Treatment or enhancement?

Testosterone today occupies two worlds at once. As a prescription medicine, it replaces a hormone that a diagnosed condition has left missing. FDA's regulation of it is still changing:

TRAVERSE concerned hormone replacement in men with hypogonadism. Its findings do not establish the safety of supraphysiologic, unsupervised enhancement use REG-S02.

That brings the story back to its central boundary. In 1935, isolating testosterone looked like a triumph of medicine. By 1961, a promoter was selling a training method while concealing a drug. Today the same family of molecules can be a legitimate treatment, a banned performance aid, a federal controlled substance or a hidden ingredient in a supplement. These categories depend on the particular product, its contents and approved indications, the applicable rules, and the circumstances of use.

Where treatment ends and enhancement begins is not only a medical question. It is a question about what we think bodies are for, which our article on transhumanism takes up from another direction. The history of anabolic steroids suggests one practical habit: whenever someone credits a dramatic change to a pill, ask what else changed, and who is telling the story.

Substance Status & Safety

United States federal status only. Checked October 31, 2026. Informational, not medical advice. This section summarises specific sources; it is not a full clinical or toxicology review.

Testosterone: DEPO-Testosterone (testosterone cypionate injection), one specific product
Status Human prescription drug, abbreviated new drug application ANDA085635. DEA Schedule III. DailyMed page "Updated August 21, 2026"; label body "Revised September 2025" LABEL-S01
FDA position on testosterone products Approved only for men who lack or have low testosterone in conjunction with an associated medical condition REG-S02
Labelled indications (this product) Replacement therapy in males with primary hypogonadism or hypogonadotropic hypogonadism (congenital or acquired) LABEL-S01
Enhancement The label advises against athletic enhancement because safety and effectiveness for that purpose have not been demonstrated LABEL-S01
Contraindications (this product) Known hypersensitivity; male breast cancer; known or suspected prostate cancer; pregnancy; serious heart, liver or kidney disease LABEL-S01

Regulatory change in progress. Three sources describe it, and they do not all match:

A request is not proof that every product's label has changed. This article does not resolve the discrepancy (issue #33). The product-specific contraindications above reproduce the inspected label; the requested prostate and age-related wording changes remain unresolved here. TRAVERSE concerned replacement treatment and does not establish the safety of nonmedical, high-dose use REG-S02.

Anabolic-androgenic steroids (class), including methandienone (Dianabol)

Serious harms reported with nonmedical use

The following are drawn from NIDA's 2018 report and the testosterone label's abuse section. Both caution that many reports come from case studies or voluntary reports, in people who often used other drugs too, so frequency and causation cannot always be established HEALTH-S01; LABEL-S01.

Interactions and risk groups (testosterone label)

Withdrawal

Withdrawal symptoms can include fatigue, restlessness, loss of appetite, insomnia, reduced sex drive and cravings. Depression is the most dangerous, because it sometimes leads to suicide attempts HEALTH-S01. The label says withdrawal after high doses can last weeks or months LABEL-S01. FDA recommends promptly consulting a health professional about steroid-containing products, partly because stopping quickly can cause dangerous withdrawal problems REG-S03. This article gives no stopping or tapering plan.

Drug dependence has not been documented in people using approved doses of testosterone for approved indications, according to the label LABEL-S01. People prescribed testosterone should discuss routine treatment changes with their prescriber; urgent symptoms require immediate assessment and the product label’s emergency directions still apply.

Lethal-dose evidence and its limits

The testosterone label states that there have been no reports of acute overdosage with androgens LABEL-S01. That is not evidence of safety. Serious and fatal harms, such as heart attack, stroke, liver rupture or suicide, can come from use over time rather than a single overdose. NIDA notes that published case reports include deaths, though other drug use often made causation hard to establish HEALTH-S01.

The sources reviewed establish no reliable universal human lethal-dose threshold, and this article gives none. Animal toxicity figures are not human thresholds.

When to get help

Sources & Further Reading