As Ben Pakulski contemplates the future of steroids in bodybuilding and powerlifting, he evokes the 2011 Bradley Cooper movie Limitless. In the film, Cooper’s character, a struggling writer, takes a pill that expands the limits of his mental capabilities. It’s certainly not as simple as Hollywood made it out to be, but for Pakulski, a former IFBB Pro League bodybuilder who hosts the popular Muscle Expert Podcast, the central premise of the film provides at least a loose template for what the future might look like. Imagine a performance enhancing drug that can heal wounds or soothe sore muscles almost instantly, or imagine a pill that can directly trigger muscle growth and fat loss. That’s what some athletes and bodybuilders are looking for in steroids.
As science and genetics develop, Pakulski and other experts believe that the steroids of today, which have lingered in the background of competitive powerlifting and bodybuilding for decades, will soon be a thing of the past. Today, these drugs broadly target muscle-building pathways in the body and often come with crippling hormonal side effects that doctors like Thomas O’Connor, aka “the Anabolic Doc,” have to confront in his office multiple times per day. Those compounds, which date back to the mid–20th century, are always going to be around, O’Connor says, “because they work, phenomenally, and they’re accessible on the internet.”
The future, however, points toward more specialized drugs, which can be tailored to the body’s specific needs. Right now, those next-gen performance enhancing drugs include SARMs (selective androgen receptor modulators), which are essentially anabolic compounds that promise fewer steroid-related side effects; designer steroids, which are specially formulated by chemists in labs; peptides, which are molecules that activate hormone pathways in the body; and also testosterone replacement therapy, nootropic compounds designed to maximize brain function, and even—eventually—the idea of editing genes to maximize performance.
How safe are all these things? That’s something we can’t really say for certain at this point, in part because the science is still in its early stages, and in part because it’s difficult to study them too closely because they’re still viewed as taboo—particularly within competitive sports. And the potential for abuse, especially among amateurs who may not have the proper knowledge or the professional guidance, is still a serious concern.
“Some of these new things have created a lower barrier for abuse,” says one well-known powerlifter and strength coach, who prefers to remain anonymous. “It’s kind of like they get their toes wet with this stuff, and it becomes a gateway into them taking something more potent.”
In an effort to understand what the future might look like, we spoke to several experts about what they see on the horizon—and how best to understand the benefits and the risks.
According to O’Connor, athletes and amateur bodybuilders who aren’t ready to try more common steroids first turn to SARMs like ostarine and cardarine.
The S stands for “selective,” because they are designed to more effectively target androgen receptors—the structures in your body that bind with anabolic steroids to generate muscle. SARMs aren’t approved for human use, but the perception among some bodybuilders is that they work the same way old-school steroids do, without breaking down into the unwanted molecules, like estrogen, that cause nasty side effects such as acne, erectile dysfunction, and gynecomastia (“bitch tits”).
According to O’Connor, “The average person doing SARMs is a nonathlete who wants to get bigger and harder.”
Very little research has been conducted on SARMs’ long-term effects, and because they’re usually obtained on the black market, they can be contaminated with harmful substances. Some preliminary studies have shown that SARMs can suppress natural testosterone production; another study of cardarine had to be canceled because it caused cancerous growths in the intestines of mice. And according to O’Connor, if you take enough of them for an extended period, they’re going to act just like steroids—which means that side effects can still catch up to you eventually.
The same is true of so-called “designer steroids,” which are made by chemically modifying common steroids. This includes compounds that rose out of labs like BALCO, which got caught up in baseball’s 1990s steroid scandal. The allure of designer steroids is that they’re changed just enough to evade the testing process. O’Connor says wealthy athletes usually have them custom- made by chemists overseas.
“What they’re doing is blowing the dust off steroids that have never really been produced but have been ‘produced on paper,’” he says, also noting that the user is still susceptible to side effects.
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Testosterone Replacement Therapy (TRT)
A major part of trainer Ali Gilbert’s work is to help men optimize their testosterone levels. That makes her an expert in testosterone replacement therapy, which can have powerful effects for men over 40—but remains a controversial process, particularly for athletes.
The difference between steroids and TRT is often in the lower dosage—but by getting a prescription from a doctor, Gilbert says, men can also be sure that they’re not getting a tainted product.
That pure testosterone can help boost strength, mood, and stamina. So TRT will have performance-enhancing effects, though the extent often depends on the dosage and how it impacts an individual. For now, TRT remains banned in most major sports, unless you’re able to get a therapeutic exemption. The Ultimate Fighting Championship banned it in 2014, and some former fighters, such as Anderson Silva, have suggested that the United States Anti- Doping Agency should be more flexible about its usage in MMA, particularly since it can help older fighters recover faster.
The most prominent example of the purported effects of TRT may have been former UFC fighter Vitor Belfort, who took TRT and revived his career in his 30s—even as he largely refused to talk about it. (Google “TRT Vitor,” a nickname given to him by podcaster and UFC commentator Joe Rogan, and you’ll see the drastic difference it made in his body.) Other MMA fighters, including Dan Henderson and Chael Sonnen, admitted undergoing TRT before it was banned. Sonnen told reporters his doctor had prescribed it for hypogonadism—a condition brought on by testosterone deficiency that can lead to decreased sex drive and depression, among other things—and that “I either take this medicine or die.”
Gilbert believes that TRT will become more common over the course of the coming decades, in part because of environmental factors that she believes have caused lower T levels in men. Gilbert points in particular to endocrine-disrupting chemicals in plastics, beauty products, and lotions, which studies have shown can lower testosterone levels, even in young men. “That’s creating a problem,” she says. “It’s this big fight against the environment that men (and women) are fighting.”
It’s possible, Gilbert says, that the majority of men will be on TRT within 30 years—she points to one expert who projected that men could become infertile as soon as 2060. And if the process does become that common, it will prove almost impossible to ban it for athletes.
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Peptides
For Pakulski, the most fascinating possibilities lie with compounds generally known as peptides, which can specifically target certain pathways in the body—they can essentially “transcribe” new DNA, which alters the way our bodies look and feel. Pakulski notes that science is getting better at targeting those pathways without the same level of external stimuli—so we can get stronger or lose more fat without working out as hard, for instance. Because they’re more targeted, peptides are thought to have fewer side effects, though they don’t have the same anabolic impact as steroids.
Human growth hormone—and the substance that HGH stimulates the liver to produce, known as IGF-1—is one of the most commonly known peptides. The effectiveness of both HGH and IGF-1 as muscle builders and anti-aging drugs is the subject of ongoing controversy, but they can cause side effects like joint and muscle pain, increased insulin resistance, and even a higher risk of certain cancers.
Pakulski points to scores of other peptides that are just being explored. These could change the way we view and treat the human body in general, not to mention their impact on performance.
“The reason we exercise is that we’re trying to get certain genes to turn on that will ultimately change our body,” he says. But peptides, if they live up to their promise, could help you make those changes more easily. In other words, Pakulski says, you “no longer need to exercise as much, you no longer need to do as much cardio, because you’re literally just bypassing the need for the physiological stimulus. That’s the future of disease prevention—that’s the future of really everything.”
Pakulski says he’s spoken to a biochemist who’s working on a peptide that could accelerate healing. Other scientists, he says, are working on creating implants that will be able to gauge each body’s optimum nutrient levels—and eventually, we may be able to target peptides to address our weaknesses.
Rather than taking testosterone or HGH, Pakulski says, we may be able to take a peptide that allows our own bodies to increase their production of those substances. It won’t have the immediate effect that steroids do, but the impact on medicine could be substantial.
The science is already far enough along that there are peptides that can specifically target fat loss. There are also brain peptides with nootropic effects that can help ramp up the brain’s ability to function (and are already being used by some—the Esports team Gankstars was sponsored by noo-tropics maker HVMN in 2016).
As with other performance enhancers, many of the peptides available online are manufactured overseas with little regulation, so they may not contain the substances they claim to. And while peptides may prove to be safer than anabolics eventually, as the anonymous powerlifter and strength coach notes, the overarching perception of the moment—that peptides are undeniably safer—can also be deceptive.
“Someone might say, ‘Oh, yeah, peptides are relatively safe, I’m going to get into peptides,’ ” he says. “Well, insulin is a peptide. And insulin will kill you. You’ve got two minutes if you go wrong with insulin.”
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What’s the future?
It’s too soon to know the full range of these substances’ side effects. Right now, peptides are largely legal for use by the general public and competitive athletes, but Pakulski thinks that may change. Additionally, some substances—including certain peptides—are extremely difficult to test for, which could allow athletes to get away with using them until the USADA and other organizations catch up.
In the meantime, the hope is that the science and the understanding of our own bodies will advance to the point that these compounds can be used safely and effectively, without the tendency toward excess that old-school steroids have wrought. There’s hope, too, that pro athletes will even—-tually be steered toward safer substances than the ones they may be taking under the table now.
But until that moment, experts advise caution, no matter what path you choose to take. And then there’s the larger moral question of when the use of these substances is justified, and when it isn’t—an issue that will also have to be sorted out as the science advances into new realms.
“I’ve prescribed testosterone all day long to accountants and lawyers who need it,” O’Connor says. “What’s the difference between that and prescribing it to a young MMA fighter or Major League Baseball player, or a bodybuilder who’s using it as a steroid? To me, it’s ethical. There’s an ethical difference that the young man doesn’t need it and the patient who’s a lawyer needs it.”
