Ergogenic and metabolic effects of oral glucocorticoid intake during repeated bouts of high-intensity exercise

doi:10.1016/j.steroids.2014.04.008

Steroids

Volume 86, August 2014, Pages 10-15

https://doi.org/10.1016/j.steroids.2014.04.008 Get rights and content

Highlights

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No study has yet investigated its impact during repeated high-intensity exercise.
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Short-term GC does not improve endurance performance during this type of exercise.
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Short-term GC induces an initial increase in absolute peak force.
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Short-term GC alters DHEA but not testosterone or blood lactate concentrations.
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Short-term GC demonstrates an anti-inflammatory effect at rest and during exercise.

Abstract

All systemically administered glucocorticoids (GC) are prohibited in-competition, because of the potential ergogenic effects. Although short-term GC intake has been shown to improve performance during submaximal exercise, literature on its impact during brief intense exercise appears to be very scant. The purpose of this study was to examine the ergogenic and metabolic effects of prednisone during repeated bouts of high-intensity exercise. In a double-blind randomized protocol, ten recreational male athletes followed two 1-week treatments (Cor: prednisone, 60 mg/day or Pla: placebo). At the end of each treatment, they hopped on their dominant leg for 30 s three times consecutively and then hopped until exhaustion, with intervals of 5 min of passive recovery. Blood and saliva samples were collected at rest and 3 min after each exercise bout to determine the lactate, interleukin-6, interleukin-10, TNF-alpha, DHEA and testosterone values. The absolute peak force of the dominant leg was significantly increased by Cor but only during the first 30-s hopping bout (p < 0.05), whereas time to exhaustion was not significantly changed after Cor treatment vs Pla (Pla: 119.9 ± 24.7; Cor: 123.1 ± 29.5 s). Cor intake lowered basal and end-exercise plasma interleukin-6 and saliva DHEA (p < 0.01) and increased interleukin-10 (p < 0.01), whereas no significant change was found in blood lactate and TNF-alpha or saliva testosterone between Pla and Cor. According to these data, short-term glucocorticoid intake did not improve endurance performance during repeated bouts of high-intensity exercise, despite the significant initial increase in absolute peak force and anti-inflammatory effect.

Introduction

Under current World Anti-Doping Agency (WADA) legislation, all glucocorticoids (GC) are prohibited in-competition when administered systemically, although other routes of administration, topical or local, are permitted. A review of the current knowledge about the effects of steroids on performance suggests that the ergogenic or lack of ergogenic effects of GC are linked to several factors: (1) the route of administration is a key factor, since improved performance has been demonstrated only following systemic administration [1], [2], [3], and not after inhalation of GC [4], for which the doses are much lower; (2) the mode of administration is also involved, since improved performance is found after short-duration intake, i.e., 1 week [1], [2], [3], but not after acute intake [5], [6]; and (3) the intensity of exercise appears to be crucial, although gender does not [3], [7]. However, literature on the impact of short-term GC on performance and recovery during exhaustive brief intense exercise appears to be very scant, with research limited to one study [8], despite the likelihood of widespread GC use by athletes in this context. Indeed, the physiological properties of GC suggest that they might also enhance performance during this type of exercise. The neurostimulatory effects at cerebral GC receptors could reduce fatigue, and the anti-inflammatory and analgesic effects could inhibit sensations of muscle pain during effort and raise the fatigue threshold [9].

This study therefore evaluated the ergogenic effects of GC (prednisone, 60 mg/day/1 week) during repeated brief intense exercise in trained recreational male athletes. We hypothesized that the major anti-inflammatory effects of GC that are well documented at rest would remain during exercise and thereby induce significant improvement in high-intensity performance. To test this hypothesis, blood samples were collected at rest and during exercise to determine the pro- and anti-inflammatory cytokines. In parallel, performance, lactate, and steroid hormone concentrations were assessed.

Section snippets

Subjects

Ten healthy, physically active, male volunteers (mean SD: age: 20.6 ± 0.9 years; weight: 69.8 ± 5.2 kg; height: 1.77 ± 0.05 m) agreed to participate in the study after being informed of the nature of the experiments. Ethics committee approval and written informed consent were obtained. The subjects had been running/swimming or playing soccer three to five times per week for at least 3 years and were screened with a medical history and physical examination. Subjects were asked to maintain their exercise

Results

No training effect was found in this study. Indeed, the times to exhaustion for the initial familiarization trial (119.0 ± 24.2 s) and the Pla trial (119.9 ± 24.7 s) were not significantly different.

Short-term Cor ingestion produced a significant increase in Fmax but only during the first 30-s hopping bout (p < 0.05), with no significant changes during the other hopping bouts (Table 1). Time to exhaustion was not significantly altered by Cor intake (time to exhaustion: Cor: 123.1 ± 29.5 s, Fig. 1). No

Discussion

The major finding of the current study is that short-term oral glucocorticoid administration at a therapeutic dose induces significant changes in DHEA and cytokine concentrations during brief intense exercise, without having any significant repercussions on blood lactate or testosterone. In parallel, short-term GC intake did not improve endurance performance during repeated bouts of high-intensity exercise, despite the significant initial increase in absolute peak force and anti-inflammatory

Conclusion

It appears that a systemic, high therapeutic dose of glucocorticoid has no doping effect on endurance performance during repeated brief intense exercise, but it may benefit athletes’ sprint ability. Further studies are needed to determine whether these results in recreationally trained subjects are applicable to elite athletes. Indeed, previous studies investigating the glucocorticoid ergogenic effects during submaximal exercise seemed to show a more marked increase in performance with GC

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Acknowledgments

This project was carried out with the support of the World Anti-Doping Agency (WADA). The authors wish to express their gratitude to the subjects for their dedicated performance. In addition, we likewise thank the CHU of Kremlin-Bicêtre, the nurses and Cathy Carmeni for their expert assistance.

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Analgesics are used widely in sport to treat pain and inflammation associated with injury. However, there is growing evidence that some athletes might be taking these substances in an attempt to enhance performance. Although the pharmacologic action of analgesics and their use in treating pain with and without anti-inflammatory effect is well established, their effect on sport performance is debated. The aim of this review was to evaluate the evidence of whether analgesics are capable of enhancing exercise performance and, if so, to what extent. Paracetamol has been suggested to improve endurance and repeated sprint exercise performance by reducing the activation of higher brain structures involved in pain and cognitive/affective processing. Nonsteroidal anti-inflammatory drugs affect both central and peripheral body systems, but investigation on their ergogenic effect on muscle strength development has provided equivocal results. The therapeutic use of glucocorticoids is indubitable, but clear evidence exists for a performance-enhancing effect after short-term oral administration. Based on the evidence presented in this review article, the ergogenic benefit of analgesics may warrant further consideration by regulatory bodies. In contrast to the aforementioned analgesics, there is a paucity of research on the use of opioids such as tramadol on sporting performance.
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The effects of blood lactate following short term GC treatment have received minimal attention in previous studies. The reason for this may be the conflicting results, studies report normal47,49,52 and increased45,48,51 blood lactate responses during exercise following GC treatment in comparison to the placebo. An increase in the sodium-potassium pump activity is associated with an increase in glycolytic activity as a result of an increase in blood lactate levels.51
Glucocorticoids (GC) are commonly used in the treatment of inflammatory conditions. Chronic GC administration has severe side effects that can decrease exercise capacity and, as a result performance. The side effects of acute (single dose) and short term (<7 days) GC administration are less severe, therefore the impact on exercise performance is unclear. Consequently, it is of interest to determine the influence of acute and short term GC administration on exercise capacity and performance and investigate the relationship with metabolism.
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Included in the review were studies with healthy volunteers that reported exercise capacity and performance outcomes following acute and short term GC ingestion. Additionally, the relationship of exercise, GC ingestion and metabolism was investigated.
Acute GC treatment appears to have minimal effects on exercise performance at intensities between 60 and 90% of VO_2max. Short term GC treatment improved performance in the majority of studies at various exercise intensities. In general, blood glucose values increased whilst insulin and lactate values remained unchanged following GC administration. However, inconsistencies in metabolic results are present and may be due to variations in exercise protocols and the type and dosage of drug treatments.
Acute GC administration has a minimal effect on exercise capacity and performance while short-term GC administration is likely to improve performance. Future studies should focus on the effects of GC on exercise performance and exercise metabolism during and post exercise to determine the effects on exercise capacity.
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However, using similar GC administration and a similar recreationally active population, the same team more recently demonstrated [13] an improvement in performance during a single one-legged kicking bout to exhaustion, without a change in the loss of muscular force generating capacity. Lastly, in 2014 Zorgati et al. [14] examined the ergogenic effects of 7 days of 60 mg of prednisone PO in male recreational athletes during repeated bouts of high-intensity exercise consisting of hopping on the dominant leg for 30 s three times consecutively and then hopping until exhaustion, with 5-min intervals of passive recovery. The absolute peak force of the dominant leg was significantly increased by GC but only during the first 30-s hopping bout, whereas time to exhaustion was not significantly changed after GC treatment [14].
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Glucocorticoids and physical performance: A systematic review with meta-analysis of randomized controlled trials
2023, Frontiers in Sports and Active Living
Prevalence of Prohibited Substance Use and Methods by Female Athletes: Evidence of Gender-Related Differences
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View full text

Ergogenic and metabolic effects of oral glucocorticoid intake during repeated bouts of high-intensity exercise

Highlights

Abstract

Introduction

Section snippets

Subjects

Results

Discussion

Conclusion

Declaration of interest

Acknowledgments

Cell Stress Chaperones

J Sci Med Sport

J Chromatogr B Analyt Technol Biomed Life Sci

Steroids

Clin Neurol Neurosurg

Effects of short-term prednisolone intake during submaximal exercise

Med Sci Sport Exerc

Short term glucocorticoid intake combined with intense training on performance and hormonal responses

Br J Sports Med

Short-term glucocorticoid intake improves exercise endurance in healthy recreationally-trained women

Eur J Appl Physiol

Four weeks’ corticosteroid inhalation does not augment maximal power output in endurance athletes

Br J Sports Med

Effect of acute prednisolone intake during intense submaximal exercise

Int J Sports Med

Effects of acute prednisolone administration on exercise endurance and metabolism

Br J Sports Med

Effect of dexamethasone on skeletal muscle Na+, K+ pump subunit specific expression and K+ homeostasis during exercise in humans

J Physiol

Glucocorticoids improve high-intensity exercise performance in humans

Eur J Appl

Evidence on ergogenic action of glucocorticoids as a doping agent risk

Phys Sports Med

Mechanographic characteristics of adolescents and young adults with congenital heart disease

Eur J Pediatr

Muscle force and power in obese and overweight children

J Musculoskelet Neuronal Interact

Reproducibility of jumping mechanography in healthy children and adults

J Musculoskelet Neuronal Interact

Effect of dexamethasone on skeletal muscle Na⁺, K⁺ pump subunit specific expression and K⁺ homeostasis during exercise in humans