Intended for healthcare professionals

Letters

Bodybuilders find it easy to obtain insulin to help them in training

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7089.1280 (Published 26 April 1997) Cite this as: BMJ 1997;314:1280
  1. S L Elkin, Registrara,
  2. S Brady, House officera,
  3. I P Williams, Consultant physiciana
  1. Hemel Hempstead Hospital, Hemel Hempstead, HP2 4AD

    Editor—We have recently been involved in the care of a 21 year old amateur bodybuilder, who was admitted after taking an excessive amount of insulin intravenously. He developed severe brain damage after prolonged neuroglycopenia. His case brought several points to our attention. Since anabolic steroids have been designated illegal in competitive sport, athletes have been looking for alternative drugs to help them put on muscle mass and burn off fat. With little understanding of the potentially serious side effects, they are now using preparations that have no proved benefit in sports training.

    After reading several bodybuilding magazines and scanning numerous internet web sites we have realised that the extent of misuse is considerable and growing. Some of the drugs advocated are testosterone, insulin, insulin-like growth factor 1, thyroxine, erythropoietin, clenbuterol (a ß2 agonist and veterinary drug used to promote muscle growth in exhibition livestock), and mifepristone (which is said to be anti-catabolic).

    Although there is some evidence in favour of testosterone increasing fat free mass and muscle storage when combined with strength training,1 there is no evidence that other drugs do the same.2 It is worrying that a drug such as insulin is being described as “the most powerful anabolic hormone on the planet”3 to a readership that can be obsessive and often has a poor body image.4 We could find no evidence in the literature to support the use of insulin in this context.

    It became apparent to us how easy it is to obtain insulin from pharmacies, and that this fact is better known to bodybuilders than to doctors. Insulin is a P drug, which means that it can be obtained without a prescription at the pharmacist's discretion. We were able to buy soluble insulin over the counter without any prescription or identification. We are not diabetic. This case has identified two problems. Firstly, the availability of uncensored information on the internet is growing, encouraging the use of drugs such as insulin. Secondly, it is easy to obtain insulin once you know how. Perhaps the Department of Health should review its policy on the sale of insulin.

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