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When Thinking About Baseball Doesn't Work

A: Antidepressant medications are often used for premature ejaculation (or in your case what isn't quite PE). Paroxetine (Paxil) at 20 mg/day (Paxil) seems to be the most efficient of the various SSRI’s studied for this use.

Other than that, I suppose one may want to give clonidine a try as that may help. However, I’d rather see someone give an SSRI a try before using clonidine (a 2-adrenergic agonist).

As far as supplements that might help in that regard, ephedrine may help in an indirect manner (norepinephrine release), but being as it’s rather nonselective it's not a great choice. Besides, it's going to be tough to find pretty soon given the ban.

Last but not least, you could simply rely on your body’s own physiological response to an orgasm (increased prolactin) and just masturbate before the big date. Just try to avoid any embarrassing Something About Mary incidents.


New Performance Drug?

A: Darbepoetin alfa (Aranesp) is an analogue of epoetin alfa (Procrit ). Quick review: Epoetin alfa is recombinant human erythropoietin being manufactured via recombinant DNA technology involving isolation of the human erythropoietin (EPO) gene. It's then inserted into cultured mammalian cells that are capable of synthesizing unlimited quantities of the glycoprotein/hormone. It should be noted, however, that although the amino acid sequence of epoetin alfa is identical to that of erythropoietin, their glycosylation patterns are different.

For those of you who don’t know what erythropoietin is or what it does, let me explain. EPO is an endogenous (found naturally in the body) glycoprotein/hormone that is secreted primarily by the kidneys when oxygen levels are low. It binds to the erythropoietin receptor on erythroid progenitor cells, and both prevent apoptosis and promote the proliferation as well as differentation of the erythroid progenitors cells found in bone marrow to form mature erythrocytes or RBC’s (red blood cells). In other words, it stimulates the production of RBC’s, otherwise called erythropoiesis.

Major sports associations ban the use of erythropoietin because it gives athletes a possible advantage. Since erythropoietin stimulates RBC production, the excess RBC’s can allow for extra oxygen transport to muscles, thus prolonging or improving endurance. Obviously endurance athletes would greatly benefit from this stuff. It can potentially help bodybuilders with vascularity as well.

However, I want to make it clear that the use of erythropoietin can be dangerous. Excess RBC’s can cause clots in blood vessels in the brain and trigger a stroke, which can lead to a negative side effect doctors refer to as death.

Getting back to darbepoetin alfa specifically, it’s an analogue of epoetin alfa, the main difference being that darbepoetin has a longer half-life, up to threefold longer (4 to 13 hours vs. around 25 hours) than epoetin alfa. It was found that while darbepoetin alfa has a lower binding affinity as compared to both epoetin afla and endogenous erythropoietin, the longer half-life results in a greater bioactivity and requires less frequent dosing. The difference in half-life with darbepoetin as compared to epoetin alfa can ultimately be attributed to the fact that it has two additional N-linked carbohydrate chains.

As far as darbepoetin's actual use in medicine, it’s FDA approved for treatment of anemia associated with chronic renal failure (requiring dialysis), as well as anemia associated with chronic renal insufficiency (not requiring dialysis). Last, it’s approved for anemia associated with chemotherapy.

Darbepoetin has also been used for treatment for anemia associated with cancer but this is an "off-label" use. It comes in solutions of .025 mg/ml, .04 mg/ml, .06 mg/ml, 0.1 mg/ml and 0.2 mg/ml. It can be administered intravenously or subcutaneously. Very generally speaking, it’s administered once every one to two weeks at dosages ranging from 45 mcg/kg to 4.5 mcg/kg depending on what it’s being used to treat.

Common side effects listed are edema, fatigue, diarrhea, headache, hypertension/hypotension, infection and myalgia. Serious side effects are listed as dehydration, dyspnea, fever, pneumonia, vomiting, arrhythmia, CHF, sepsis and vascular access thrombosis.

Keep in mind that these are the side effects listed for those with conditions requiring the medical use of the compound. Still, hypertension and stroke are very real possibilities to consider when a normal human is using such compounds. I personally wouldn't advocate their use in athletes or bodybuilders.


Will Bonds Lose His Bat?

A: Well, I’m not an expert in baseball, but assuming his increased performance was primarily due to increased strength from steroids, it’s perfectly possible that he’ll maintain a great deal of his hitting performance.

While most guys who come off of an androgen cycle improperly won't maintain much of their gains in muscle mass, they’ll still typically retain a great deal of their strength gains. If a person does actually come off properly, he'll retain a great deal of muscle mass as well as most, if not all, of his strength gains.

In fact, I’ve consistently seen people maintain their strength gains after androgen cycles, more often than not with a 5-10% drop (at most) in their peak 1RM while using androgens, and some actually continuing to gain strength. Now, this is going to hold true more so for those guys who are already experienced in training and androgen use, as well as those who continue to train hard in a consistent fashion and eat correctly.


The Mother of All Hormones?

A: While I’m sure some have referred to it as a "mother hormone," that’s not entirely accurate. While it can certainly be considered the mother of all hormones, it's not itself classified as a hormone, at least not right now. It is a steroid though.

As for why it’s considered the "mother" of all steroid hormones produced in the human body, well, that’s because it’s the immediate precursor to just about every one of them. In fact, it’s the precursor to more than 150 human steroid hormones, including DHEA, progesterone, estrogen, Testosterone, and cortisol. Pregnenolone itself is synthesized from cholesterol via a cytochrome P-450 side chain cleavage enzyme.

Other than that, it's classified as being a neurosteroid, synthesized in the central and peripheral nervous system. The vast majority of literature on neurosteroids and particularly pregnenolone has focused on cognition and behavioral effects related to the brain. Specifically, it may improve memory and may possess an anxiolytic (anti-anxiety) effect in that regard.

Along those lines, it’s also been shown that pregnenolone behaves as a sigma(1) receptor agonist. This could be important because the intracellular sigma(1) receptor seems to play a significant role in terms of memory, depression, stress, and learning. Antagonists of this receptor however, affect such parameters in a negative fashion. Progesterone is a sigma(1) antagonist and may be why nandrolone, due to its progestational activity, has a negative effect on mood.

Pregnenolone, in one study at least, was shown to improve the sleep efficiency index of normal volunteers. As far as the dosage, start at 1 mg just prior to sleep if you wish to replicate the study where they found an improvement in sleep efficiency. Other than that, 25-50 mg a day is used for other purposes. It may also act as an antioxidant and may enhance immune function.


Smart Supplements for Better Grades

A: Before studying, you may find that adding a small amount of vinpocetine (2.5-5 mg) to your Power Drive helps as it may improve blood flow to the brain. The reason I specify a lower dosage is simply because it and the ginko biloba may be working to accomplish essentially the same thing. Some may find that using HOT-ROX for the forskolin is of benefit as well.


Tittie-Free Testosterone

A: Testosterone preparations containing an aromatase inhibitor (usually anastrozole) seem to have been around for a fair amount of time, so yes, there are such products out there.

As far as it being a good stand-alone combination, I don’t see why not. Testosterone is one of the few androgens many have found to work very well when used by itself. Having an aromatase inhibitor included is simply preventing one from having to worry about gynecomastia (bitch tits).


Tanning Pills for that Healthy Orange Glow

A: Canthaxanthin is a naturally occurring, orange carotenoid lacking any vitamin A properties. It was once very popular amongst those trying to produce an artificial tan as it acts as a dye causing the skin to become orange-brown to red by essentially staining the skin and the adipose tissue below it.

Canthaxanthin is naturally present in the diet (~5.6 mg/day) in smaller amounts. Aside from that, it's found in various plants, sunflowers, seaweed, mushrooms, and is also found in some trout and salmon as some are fed the compound to help color their skin.

As far as possible side effects, in those taking large amounts over an extended period of time for artificial tanning purposes, development of bright yellow retinal deposits (flakes or crystals) are possible. Whether those deposits resulted in deterioration of eyesight or cause an alteration in vision was a subject of debate. In any event, while the deposits don’t seem to affect vision (in most cases) and usually subside, it’s not something I personally would want to deal with.

Those ingesting at least 37 grams over a period of time stand about a 50% chance of getting those retinal deposits while those consuming 60 grams stand a 100% chance with continued use as the compound is eliminated very slowly.

Aside from that, there are some reported cases of hepatotoxicity associated with its use.

I’ve seen people who use this product and from the look of their skin, the potential for any adverse effects outweigh the "beneficial" effects. They end up looking more orange than anything else!

As for why it can’t be sold as a "tanning pill," that’s because canthaxanthin isn't approved for use by the FDA and thus it has to be sold as a "skin care" product. I would not recommend it!


References Cited

1) Egrie JC & Browne JK: Development and characterization of novel erythropoiesis stimulating protein (NESP). Nephrol Dial Transplant 2001; 16:3-13.

2) Macdougall IC: Novel erythropoiesis stimulating protein. Semin Nephrol 2000; 20(4):375-381.

3) Rupprecht R & Holsboer F: Neuropsychopharmacological properties of neuroactive steroids. Steroids 1999; 64(1-2):83-91.

4) Isaacson RL, Yoder PE & Varner J: The effects of pregnenolone on acquisition and retention of a food search task. Behav Neural Biol 1994; 61(2):170-176.

5) Steiger A, Trachsel L, Guldner J et al: Neurosteroid pregnenolone induces sleep-EEG changes in man compatible with inverse GABAA-receptor modulation Brain Res 1993; 615(2):267-274.

6) Meieran SE, Reus VI, Webster R, Shafton R, Wolkowitz OM. "Chronic pregnenolone effects in normal humans: attenuation of benzodiazepine-induced sedation." Psychoneuroendocrinology. 2004 May;29(4):486-500.

7) Waldinger MD, et al. "Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis." Int J Impot Res. 2004 Feb 12 [Epub ahead of print]

8) Waldinger MD, Hengeveld MW, Zwinderman AH, Olivier B. "Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline." J Clin Psychopharmacol. 1998 Aug;18(4):274-81.

9) Waldinger MD, Zwinderman AH, Olivier B. "Antidepressants and ejaculation: a double-blind, randomized, placebo-controlled, fixed-dose study with paroxetine, sertraline, and nefazodone." J Clin Psychopharmacol. 2001 Jun;21(3):293-7.

10) Waldinger MD, Zwinderman AH, Olivier B. "SSRIs and ejaculation: a double-blind, randomized, fixed-dose study with paroxetine and citalopram." J Clin Psychopharmacol. 2001 Dec;21(6):556-60.

11) Kruger TH, et al. "Orgasm-induced prolactin secretion: feedback control of sexual drive?" Neurosci Biobehav Rev. 2002 Jan;26(1):31-44.

12) Rampin O. "Pharmacology of alpha-adrenoceptors in male sexual function." Eur Urol. 1999;36 Suppl 1:103-6.

13) Loria RM. "Antiglucocorticoid function of androstenetriol." Psychoneuroendocrinology. 1997;22 Suppl 1:S103-8.

14) Reich IL, Reich HJ, Kneer N, Lardy H. "Ergosteroids V: preparation and biological activity of various D-ring derivatives in the 7-oxo-dehydroepiandrosterone series." Steroids 2002 Mar;67(3-4):221-33

15) Lardy H, Kneer N, Wei Y, Partridge B, Marwah P. "Ergosteroids. II: Biologically active metabolites and synthetic derivatives of dehydroepiandrosterone." Steroids 1998 Mar;63(3):158-65 Erratum in: Steroids 1999 Jul;64(7):497

16) Hampl R, et al. "7-Hydroxydehydroepiandrosterone—a natural antiglucocorticoid and a candidate for steroid replacement therapy?" Physiol Res 2000;49 Suppl 1:S107-12

17) Catania RA, Angele MK, Ayala A, Cioffi WG, Bland KI, Chaudry IH. "Dehydroepiandrosterone restores immune function following trauma-haemorrhage by a direct effect on T lymphocytes." Cytokine 1999 Jun;11(6):443-50

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