Many competitive bodybuilders take anabolic steroids to achieve their freakishly exaggerated physiques. That is no secret. But steroids can be only one part of an extreme regimen that can wreak havoc on the body.

Human growth hormone, supplements, painkillers and diuretics can also be used to create the “shrink-wrapped” muscles so prized in the aesthetic. And the high concentration of muscle mass puts stress on the body, as if the lifter were obese.

Lifting weights in the gym is “extremely healthy for you,” said Kenneth Wheeler, a former elite bodybuilder known as Flex. “But if you want to be a bodybuilder and compete at the highest level, it has nothing to do with health.” A relatively rare form of kidney disease forced Wheeler to retire in 2003 at age 37, and he needed a kidney transplant later that year.

Determining the extent of the damage that bodybuilders inflict on themselves is difficult, in part because there is little interest in financing studies on such an extreme group, and because bodybuilders are not always honest about what they take. That is why a case study published last month by a top kidney journal is generating interest in the nephrology and bodybuilding communities. It is among the first to assert a direct link between long-term steroid use and kidney disease.

The study began 10 years ago when a kidney pathologist at Columbia University Medical Center in New York noticed that a bodybuilder had an advanced form of kidney disease. Curious, she started looking for similar cases and eventually studied 10 men with serious kidney damage who acknowledged using steroids. Nine were bodybuilders and one was a competitive powerlifter with a similar training routine.

All 10 men in the case series, published in November by the Journal of the American Society of Nephrology, showed damage to the filters of the kidney. Nine had an irreversible disease known as focal segmental glomerulosclerosis — the same disease contracted by Wheeler — even though the men in the study did not have other apparent risk factors. Their disease was worse than in obese patients with a higher body-mass index, suggesting that steroids — combined with the other practices — might be harming the kidneys.

Among the study’s most persuasive details is the story of a man, 30 years old at the time, who damaged his kidneys after more than a decade of bodybuilding. The patient’s condition improved after he stopped using the drugs, discontinued his regimen and lost 80 pounds. But it worsened after the man, who became depressed, returned to bodybuilding and steroids.

“These patients are likely the tip of the iceberg,” said Vivette D. D’Agati, the lead researcher. “It’s a risk. A significant risk.”

Several experts not affiliated with the study said that while the claims were intriguing, the study’s value was limited because it focused only on intensive steroid users and because the bodybuilders’ layered training practices had to be taken into account. “I think it’s hard to be certain what’s causing their kidney disease,” said William Bremner, chairman of the Department of Medicine at the University of Washington and an endocrinologist who studies steroids.

D’Agati said, “It’s probably multiple factors that are converging in these patients, but the common entity in all of them is anabolic steroids.”

One participant in the study, Patrick Antonecchia, 46, competed in powerlifting and strong man events for more than 25 years and said he used steroids, supplements and a high-protein diet to attain feats such as pulling a 40,000-pound truck. He ended his career and stopped using steroids about a year ago, and in February received a diagnosis of serious kidney damage. His doctors warned him not to use the drugs again. “They said: ‘Pat. Don’t. Because it comes back,’ ” he said.

Antonecchia has lost about 50 pounds and said he misses the attention his 290-pound frame attracted: “The toughest thing now is it was my identity for 25 years. Now, when people see me, they say, ‘What happened to you?’ ”

Jerry Brainum writes a column for Iron Man Magazine called Bodybuilding Pharmacology and said he welcomes more research on the subject. “I found it very alarming, quite frankly,” Brainum said.

Since the 1990s, at least eight accomplished bodybuilders have died at a young age, and in addition to Wheeler, another six were forced to stop competing because of serious illness, often involving kidney disease.

The main source of information for bodybuilders is word of mouth and experimentation, Brainum said. “These guys have no guidance, they talk among themselves, and they don’t even tell the truth to each other,” he said.

The risk-taking has been made worse by a trend toward ever larger physiques among the sport’s top competitors, some said. Jay Cutler, who won the 2009 Mr. Olympia contest, weighs almost 40 pounds more than Arnold Schwarzenegger did when he won the title in 1974, even though Cutler is five inches shorter.

“Each decade you have a guy that comes along that sets new standards and you say O.K., now I’m going to have to take it to the next level,” said Shahriar Kamali, a professional bodybuilder known as King.

The International Federation of Body Building and Fitness reserves the right to test for steroids and human growth hormone at the professional level, and testing is done on a random basis, said Bob Cicherillo, athlete representative for the federation, which is the main governing body for bodybuilding.

But several bodybuilders said the testing was nearly nonexistent, and Cicherillo said he could not provide specific figures on competitors who tested positive. In addition, the chairman of the organization’s medical commission, Robert M. Goldman, is a leading champion of the anti-aging effects of human growth hormone, a drug that is banned by most sports governing bodies.

James Manion, who runs the professional division of the federation, did not return several calls seeking comment.

Some bodybuilders expressed doubt that their practices were dangerous, pointing to former competitors who are still healthy in their 70s. They attributed the deaths of elite bodybuilders to the abuse of over-the-counter painkillers and diuretics, not steroids. The bodybuilding federation tests for diuretics at professional events, although competitors said they are still used.

Bodybuilders said that they were unfairly singled out as drug abusers when athletes in most other sports were also using performance-enhancing drugs. “Like anything else, it’s use and abuse,” Cicherillo said. “We’re the ones who are visual. We’re the ones who walk around, and you see us with the big muscles.”

Wheeler said he was convinced steroid use did not cause his kidney disease, although it might have made it worse.

The patient whose case was the centerpiece of the kidney study said he was most likely predisposed to develop the condition. “The drugs weren’t the reason I got sick,” said the man, who declined to be identified because his steroid use was illegal. After taking a year off from steroids and bodybuilding because of the kidney disease, the man, age 34, is returning to competition. His symptoms have worsened, a sacrifice he said he is willing to accept.

“It’s just really hard to walk away from it,” he said. “I know I can only do this until my early 40s, so I really want to give it my all now.”

A version of this article appeared in print on December 10, 2009, on page B13 of the New York edition.

12月9日的「紐約時報」（New York Times）針對健美選手使用類固醇等禁藥造成腎臟的傷害做了一篇特別報導：「Bodybuilders See Kidney Damage With Steroids」。

文章中訪問了目前職業健美界的幾位要角，其中換過腎的前職業選手Flex Wheeler 說了句最貼切的話：
「“But if you want to be a bodybuilder and compete at the highest level, it has nothing to do with health.”」
（如果你是打算參加最高層級健美賽的選手；那練健美就跟健康沒什麼關係了）

至於健美界人士對一般外界認為健美選手都是用藥者的反應，普遍的回應是：
「“Like anything else, it’s use and abuse,”」
（跟任何運動項目都一樣：不但用而且濫用）。

「紐約時報」這篇文章內容雖然令大部分健美界很不以為然，但這也反應出在美國極具權威與代表性的媒體對健美的看法就是這樣！
getbig.com The New York Times on IFBB, Pro bodybuilders & steroid

自從1990年代末到2000年初開始，為什麼健康出問題的職業健美選手愈來愈多？水牛肚、心臟病、腎臟病……不斷發生；甚至死亡！

別的不說，光就我自己所認識與過去一同在日本上場表演的職業健美選手中就有好幾位！其中最讓我震驚的是1999年跟我起在日本表演過；也就是1991年Mr.Olympia第六名的澳洲職業健美選手Sonny Schmidt ，他在2004年初突傳出暴斃的消息！

當然，美國健美界很多人會說全世界每年因抽煙死亡人數都幾百萬；所以只要「正確」用藥不要濫用就沒有什麼危險…….等等。在美國健美界持這種論調在賺選手錢的所謂「專家」一堆；他們自稱是「備賽Guru」；我就把他們音譯為「骷髏」！

那1990年代末期以前因用類固醇等禁藥出問題或死亡者也有啊，但是為什麼現在健康出問題的職業健美選手愈來愈多？

主要是現在一些選手所用的管制禁藥種類實在是太多太多了！特別是由於現在健美比賽中對選手們肌肉的「線條清晰度」要求愈來愈高，選手們使用的不止是各種利尿劑，像胰島素、IGF-1、THYROID (T3 + T4) 、瘦肉精…..等等不勝枚舉，這些都是傷害腎臟的因素。

另外很多健美選手長期使用的「止痛藥」如Nubain等等…也是造成腎臟傷害的元兇之一！


練過健美的朋友都知道；只要稍為拼命操一下；第二天肌肉沒有不酸不痛的！尤其像職業健美選手們；每天的訓練不是為了健康！而這是他的職業！他的謀生工作!

像這樣經年累月長期高強度的操練所產生的酸痛，如果沒有過人的意志力；是無法忍受的！這種痛苦的經驗像我練了三十幾年；體驗得最刻骨銘心！！！

這也是為什麼在美國的職業摔角、格鬥選手與職業健美選手使用「止痛藥」的情況最嚴重！！

二頭肌 寫道:
人家喜歡大姐姐啦

小肌肉 寫道:
大哥哥搶弟弟的菜~!哈哈

阿虎 寫道:
鐵鍊兄~麻煩教我們一下，肩部如有舊傷，要怎麼練胸和三角呢??

練重訓的人很多都在有肩傷，像是"肌腱炎"或是拉傷…等，急性期過即使是好了不會痛，但在練胸、三角甚至二頭時，有些角度出力仍會不舒服，如果拿捏的不好，還會再復發，因為受傷過的軟組織的柔軟度和血液循環就是一定會比較差。

祝你繼續進步~~~

小勇 寫道:
鐵老大啊，以后你也要寬容一點，學會接受別人的不同視角也是一種進步啊～少計較一些東西，得到的可能更多～不給自己設界限，你的發揮就會比平常更自由更出色

T.D 寫道:
目前缺一個跟我差不多的人一起練