Drug use in professional bodybuilding is not so much an issue as it is a cornerstone of the industry. Without performance enhancing drugs there would be no bodybuilding competitions and it is hard to see a future where this is not the case.
Even in the so-called ‘natural‘ bodybuilding competitions, participants are rarely drug-free, many have become adept at timing their drug use to avoid getting caught.
This article will look at the most common drugs used by Bodybuilders.
1. Testosterone & Androgenic-Anabolic Steroids (AAS)
Testosterone is one of the most popular Anabolic Steroids out there, and comes in either injectable or oral forms.
Testosterone is different to Androgenic-Anabolic Steroids in that it is produced naturally in the body.
Injectable Testosterone is used legally by lots of people who have naturally low T levels, to produce the results that Bodybuilders have Testosterone has to be taken in massive quantities. As David Handelsman (2006) wrote:
“Abusers may use any available androgens, including veterinary, illegally manufactured, stolen and counterfeit steroids, in often bizarre, high-dose regimens advocated by folkloric underground publications.” 
High Testosterone levels can lead to many benefits for bodybuilders. Testosterone increases muscle protein synthesis, so their muscles will grow faster, will increase in strength, and will recover faster from training .
Steroids can also lower body fat  and increase muscle fibre size .
Sadly there is a reason why abusing testosterone is not considered a safe practice, there have been many short and long term side-effects reported.
Acne Vulgaris, increased body hair, and increased aggressive behaviour have been reported .
Another issue is that supplementing with Testosterone can disturb the body's natural production of Testosterone.
There are also Cardiovascular risk factors, and psychological factors such as depression, mania, and psychotic features .
2. Human Growth Hormone (HGH)
HGH is a peptide hormone produced by the pituitary gland , it is created through genetic engineering and is used by many bodybuilders as (when dosed correctly) it is “efficient, hard to detect, and without major side effects” .
It is normally taken in cycles of 4-6 weeks (same as steroids), and is often taken in conjunction with AAS and EPO.
As with Testosterone and AAS, HGH is used to increase muscle size and power, and has a powerful effect on fat and carbohydrate metabolism . A study by Tavares et al (2013) found that HGH significantly increased muscle strength .
Rennie (2003) claims that HGH's effectiveness has been over exaggerated  and that the risks that come with it are too high.
The main danger of over-doing HGH is developing a condition known as Acromegaly which is where the body produces too much growth hormone leading to abnormally large hands and feet, joint pain, excessive sweating, fluid retention, and dental issues to name a few.
There is also an increased chance of developing diabetes mellitus, hypertension, and cardiomyopathy .
Produced in the pancreas, Insulin is a hormone that “regulates blood glucose by allowing your body's cells to absorb and use glucose. In turn, this drops blood glucose levels.” .
Some people may not produce Insulin properly, in which case they need to take injectable insulin so that they can regulate blood sugars properly. Bodybuilders have been known to take Insulin too, though for a different purpose.
When working in conjunction with steroids, Insulin can help Bodybuilders to train longer without suffering from catabolism (the breaking down of muscle tissue). This is because Insulin inhibits catabolism .
It also significantly increases V02, and increases Glucose metabolism  and increases muscle protein synthesis .
One of the reasons Insulin is so popular with Bodybuilders and athletes is that it is pretty much undetectable, it only has a half-life of 4 minutes in the body and is “impossible to distinguish from the athlete's own insulin” .
The negative effects of taking injectable Insulin when you're not Diabetic are simple, you could die. The chances of suffering from hypoglycaemia are hugely increased  and developing brain damage .
4. Insulin-like Growth Factor-1 (IGF-1)
A protein that is very similar to Insulin (hence the name), IGF-1 is used by bodybuilders as it enhances protein anabolism when combined with HGH .
The downsides of using IGF-1 is that you are risking Hypoglycaemia, cancer, tumours, and the enlargement of intestinal organs .
5. Selected Others
Other drugs that are used in Bodybuilding are Clenbuterol (which is used as a powerful fat-burner), Thyroid medication Thyroxin (T4) which is used to speed up metabolism.
There's DNP which inhibits ATP (which makes you burn more calories during a workout), and Diuretics which dehydrate the body of any water leaving the bodybuilder looking very lean during a show.
Finally there is Synthol which is used by some bodybuilders to fill out muscles that may be under-developed by injecting said muscle with oil.
This is just a short introduction to the use of drugs in bodybuilding, hopefully it will have opened your eyes to the dangers of taking them.
Whilst it is true that you will never reach the top of the bodybuilding pyramid without using, the risk of doing so is too high for anyone wanting to live a long and happy life.
In 1989 there was a study of competitive male and female bodybuilders in Kansas that found that 54% of the male competitors and 10% of females admitted to using steroids on a regular basis .
Given the explosion in popularity that bodybuilding has received in recent decades I suggest that this figure has only increased since. These bodybuilders are living on borrowed time, and it may be too late to save many of them.
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