AAS for older bodybuilders

Let’s face it. At around 40 we all start to see signs of aging. It can’t be denied any longer at that point. You aren’t ready to be old. Some of us have been athletes all of our lives and are not ready to be fat and happy sitting in a sports bar watching ball on a wide screen. You want to keep going. So you seek a reason why you feel sub-par. Finally after seeing about a dozen doctors you run into one that tests some endocrine values and low and behold you find that your testosterone has tanked. You are told a normal 30 year old athletic male might test at 700 ng/dL and you are something like 220 ng/dL. Not only that but your IGF-1, a marker for GH release is in the bottom of normal range. So the doc asks have you used and anabolic steroids in the past? Have you had a blow to the head? Are you exposed to any toxins at your job etc etc. Oh shit!! Your manhood is diminishing. No wonder you look at young women like they are all your daughter and the wife just seems to nag at you without even speaking. You’re turning into an old man. You want to chase pkids out of your yard and keep their football. The doc says there is a number of treatments and he rattles off a bunch of antidepressants, a few vitamins, Cialis and then mumbles something like testosterone injections and crèmes and your ears perk up. Hell no you say to yourself. I’m not growing old just yet, at least not while there are androgens that come in little bottles.

There are two general groups of performance enhancer users over 40. The first group are, through reasons other than past AAS use, have suboptimal testosterone or are hypogonadal. The second group are past or present habitual users of AAS. One would think that group one is the more responsible of the two and would diligently go about administration of their prescribed TRT never really venturing over their scripted 100 or 200 mg/w of testosterone. Not really. Testosterone seems to push the risk taker button in men and that includes bumping up the dose, blast and cruise etc.. ect. This sort of “old virgins” population can take a fair amount of compound compared to the second population since they have not been taxed by AAS in the past. The “old virgins” can get away with it for a while but age also catches up with them. So essentially, both populations can be treated pretty much the same.

60 year old bodybuilder.

The young tend toward experimentation. It’s not unusual to see a user in his 20s on 2 or more grams of AAS along with insulin and GH plus cycling with peptides. This is really the nature of man to experiment and take risks. He will do what he can get away with in the pursuit of his goals and performance enhancement is no different. Of course, the level of risk varies from individual to individual. Some have more of a self preservation instinct than others. The older male is usually a little different. He has seen the effects of abuse in performance enhancement or other areas of life and has learned from his and other’s mistakes. So, in approaching his performance enhancement, in the end, usually the older user will be looking for results more akin to optimal health, well being and a decent amount of lean muscle mass rather than to become a huffing puffing acne laden mass monster, which is more often the somewhat misguided goal of his younger counterpart.

The natural or past/present AAS male user over 40 has noticed a loss in vitality, tendency toward carbohydrate sensitivity, loss of sex drive, a notable loss of strength and muscle mass, difficulty losing body fat, achy joints and some other unfortunate and concerning signs of age and all signs of low testosterone (Harman 2005). This state is far different from the youthful male that is at or close to the peak of his athletic and sexual prowess and wishes to further excel. Where the young man has an all or nothing, live fast, balls to the wall, immortal attitude, the older man has the wisdom of past experience and wishes to restore his youthful vitality and maybe even be a little better in some ways than in his peak years. Unlike his youthful counterpart, he realizes his mortality since he has witnessed his own slow but undeniable decline. He does not wish to hasten his own end and differs from the young man who can not imagine that the end can even come since he has no frame of reference. So, how can the older male approach his enhancement whilst avoiding real health risks? First we must understand the health risks and especially those that are more so risks to older populations.

So what are these risks? They include:

1. Pesky acne and or oily skin

2. excessive sweating

3. estrogenic effects such as gynecomastia and water retention

4. dihydrotestosterone effects such as male pattern balding (MPB) and benign prostate hyperplasia (BPH)

5. elevated red blood cells (RBCs)

6. elevated blood pressure (BP)

7. organ stress

a. liver stress

b. heart enlargement

c. kidney damage

8. poor lipid profiles

9. joint pain and osteroarthritis

10. cardiovascular affects

Just about all of these are increased risks for older compared to younger men so the former must take additional precaution when approaching performance enhancement. The overriding actions one can use to limit these side effects are moderation, observation, correlation and corrective action. Moderation means starting out with a reasonable dose of a limited number of compounds, like two. Observation means observe the positive and negative effects these limited number of compounds have on health and well being. Correlation means being able to correlate the positive and negative effects to their cause i.e. is it the drug or something else that has changed. Corrective action means changing the dose or dropping the drug if the effect is correlated with the drug. If there are no side effects and very little positive effects it may be necessary to increase the dose. If the converse is true the dose should be reduced. For instance let us say you start out with 400 mg/w of testosterone with 0.5 mg of adex every other day. After 3 weeks or so the user should make some observations and it would not be out of the question to have some blood work done. Acne, oily skin and excessive sweating are noted. This is observation. These are associated with excessive testosterone. This is correlation. The dose is decreased to 300 mg/w. This is corrective action.

72 year-old Jeffrey Life.

So, let’s talk about enhancers. These include the following categories: AAS, hGH, and GH axis active peptides. There are other more exotic classes but these will suffice for this article. Along with performance enhancers there are three other indispensable components that should be optimized. These are exercise, diet and rest. Arguably these three components are much more important than the performance enhancer category. It is possible to optimize exercise, diet and rest to increase vigor and present a more youthful sense of well being without any enhancers at all. Interestingly, the attainment of just that sort of state with exercise, diet and rest is the goal and adding enhancers is just that,.. to enhance that state of well being to accent that provided by exercise, diet and rest.

AAS can be broken down into five major subclasses for our purposes here. These are the testosterones, the mild injectables, the harsh injectables, the harsh orals and the mild orals. Below are descriptions of the major compounds of each subclass along with a suggested dose range for use in older men. All of these are lower than what is usually prescribed in discussion boards and far lower than the current trends in competitive bodybuilding but, in my opinion, they are more suitable for the goals and safety of the older user.

The testosterones: are the older users main tool. Testosterone is what we are missing for the most part. It is THE MALE HORMONE that evolution or God or whoever or whatever you believe in has deemed to be what makes a man a man. In our youth we make 7-10 mg a day of this stuff . Useful preparations of testosterone include Testosterone enanthate, testosterone cypionate, Sustanon and testosterone propionate. The first three can be thought of as medium to longer acting preparations. The later is a shorter acting preparation. There are some other preparations that are either longer or shorter acting but these will suffice here. Also, there are several testosterone crèmes available but transfer to those you are in physical contact with, such as spouse, girlfriend and children makes these less desireable in my view. Typical doses of testosterone for the older athlete are 100 to 500 mg/w where 100-150 mg/w is considered a replacement dose yielding physiologic levels.

The mild injectables: have had some of the androgenic component of testosterone removed. These are clinically termed attenuated androgens (Cicardi, Castelli et al. 1997), which gives you an idea of their intended use. They are anabolic or tissue building and are great for the older lifter that needs a boost in recovery and muscle mass. The common mild injectables include nandrolone decanoate, nandrolone (Deca durabolin), phenyl propionate (Durabolin), Drostanolone propionate (Masteron), methenolone enanthate (Primobolin) and boldenone undecylenate (Equipoise).

- The nandrolones are very anabolic and convert to estrogens at a much lower rate than testosterone (Townsley and Brodie 1970). The dihydrotestosterone equivalent metabolite of nandrolone actually has less affinity for the androgen receptor than the parent compound so BPH and MPB is less of a concern with these compounds compared to an equal dose of testosterone. It does have a tendency to increase RBCs excessively (Bozzini and Alippi 1971; Gorshein, Murphy et al. 1973) in some users so hematology should be monitored when on this drug. 200-400 mg is a good range for this drug.

- Drostanolone propionate or Masteron is not as anabolic as nandrolone on its own but is very synergistic with testosterone. It will make 100 mg of testosterone feel like 200 mg. It is a DHT derivative and has distinct CNS activity meaning it is a mood elevator. It also enhances libido or sex drive. So for the older user wishing to boost mood and enhance sex drive it is a nice addition. It also seems to make a pump last longer and make the muscled look more full. It does not aromatize so added estrogen control is not a concern with this drug. It can lead to BPH so this should be considered. 100-300 mg/w should be plenty.

- Methenolone enanthate or Primobolin is considered the Cadillac of anabolic injectables by many users. It is highly anabolic with a very low side effect profile. It is often faked so difficult to obtain and very expensive. For those that are prone to side effects it is probably the most side effect free AAS ever made. 400-600 mg is appropriate

- Boldenone undecylenate or Equipoise is a veterinarian steroid. It was briefly available for human use in Europe but was removed because it caused erythrocytosis and polycythemia in too many users. This should be a concern and hematology should be monitored with use of this drug. Otherwise it is a fairly mild compound that results in slow accumulation of lean mass. It aromatizes to estrogen at about ½ the rate of testosterone so it will contribute somewhat to estrogenic side effects in some users. It will also convert into a DHT derivative, dihydroboldenone, which is more porent than the natural form. However there is little convertion to this metabolite so DHT-like side effects are not usually a problem. 200-400 mg/w is appropriate in older users.

The harsh injectables: have retained a fair amount of androgenic component but have significantly higher anabolic activity compared to testosterone. Unfortunately, they are tough on the older user and should only be used sparingly. AAS in this category are the trenbolones, which are available in acetate, enanthate and cyclohexylmethylcarbonate esters. Parabolin, containing the cyclohexylmethylcarbonate ester, was the only one available for human use. Typically at doses over 200 mg/w, or even less in some users, night sweats, shortness of breath and aggression can become problematic. Older users often have even less tolerance of these compounds. If these compounds are used they should not be incorporated for more than 6 weeks and, in my opinion, at 100-300 mg/w and adjusted to tolerance.

Mild orals: include Oxandrolone (Anavar), stanozolol (Winstrol) and Chlordehydromethyltestosterone (Turanabol). There are others such as Primobolan acetate and some designers but the three listed above will suffice for the purposes of this article. It is important to note that most orals are C17 alkylated, which makes them sopmewhat toxic to the liver and also have a negative impact on blood lipids. Anavar, Winstrol were approved for human use whilst Turanabol is more of a dirty little Eastern German secret that finally got out. None of these aromatize so estrogen control is not an issue with these compounds. All are DHT derivatives but seem to have at least some of this activity attenuated. However some users do demonstrate DHT side effects especially MPB so these should be monitored with use. All provide a distinct anabolic action.

- Anavar is very mild and has been used in the treatment of a number of debilitating diseases including wasting syndrome in AIDS (Berger, Pall et al. 1996; Berger 2000; Grunfeld, Kotler et al. 2006). It seems to be well tolerated at relatively high doses up to 80 mg/d in HIV treatment. The drug is useful in a leaning phase as it has been shown to reduce fat mass in clinical studies. A great use for this drug is on a keto diet along with a testosterone base along with an AI. 30-80 mg for up to 6 weeks is probably appropriate.

- Winstrol is also a non-aromatizing compound with high anabolic potential. It is used in the treatment of hereditary angioedema. It increases the production of C1 inhibitor which modulates clotting, fibrinolytic and complement cascades (Burge 1983; Jentsch-Ullrich, Leuner et al. 1998). What this means is less extracellular fluid is allowed to leak into it’s normal spaces leading to a much more lean and dry look (Sloane, Lee et al. 2007; Delgado, Saborido et al. 2010). It also leads toward very sore joints probably for the same “drying” reasons. Dosing can be complicated by joint soreness. Many users try to titrate the dose against the joint issues. Also, the British use raloxifene concurrently with Winstrol, which seems to offset the pain. Raloxifene is a SERM used for treatment of osteoporosis so probably has positive action in the joint and bone tissue thus elevating pain. NSAIDs also seem to help. There is some evidence that the joint pain is also related to increased release of inflammatory cytokines so NSAIDs may counter their release. Doses are in the 20-30 mg range. Younger users seem to tolerate higher doses but this is one AAS that older users tend to tolerate less. However, if it is well tolerated the pronounced anabolism and reduced extracellular fluid provide a very appealing cosmetic effect.

- Turanabol is very similar to Anavar but stronger. There is a definite muscle hardening effect 20-40 mg should cause few ill effects. Soreness in the joints should be monitored. As older users more often suffer with joint issues this can be a concern as with Winstrol.

The harsh orals include methandrostenolone (Dianabol) and oxymetholone (Anadrol). Both can cause estrogenic side effects albeit by different mechanisms or routes. At high dose both can lead to significant side effects such as hypertention, gynecomastia and other estrogenic effects including severe water retention. Fluoxymesterone (Halotestin) is another harsh oral but does not aromatize.

- Dianabol was the main drug used in bodybuilding and strength sports in the 50s, 60s and 70s. It was and is still very effective. But we have to realize that it was the first attempt at development of an attenuated androgen for use as an anabolic so it is far from perfect. As mentioned above, it aromatizes significantly and to a more powerful estrogen than estradiol, which is responsible for the characteristic water retention of this drug. This can be more detrimental in the older user where more often water retention may be a preexisting condition or the propensity thereof is increased. Effective doses of this drug can be as low as 10 mg. Dose range is 10-30 mg for up to 6 weeks. Water retention, BP, and hematology should be monitored with this drug. As with all orals liver and blood lipids are a concern.

- Anadrol provides fast temporary gains in strength and size. It does not aromatize but appears to act unchanged on the estrogen receptor. Therefore estrogenic effects can not be prevented with an AI. Use of a SERM like tamoxifen may be useful but appreas to be complicated by the possibility that Anadrol may stimulate the progesterone receptor (PR) and tamoxifen can upregulate the PR in some tissues. Side effects can be dramatic and include lethargy, flue like symptoms, tachacardia, high blood pressure, high red cells, liver toxicity and severe water retention. In my opinion there is no use for this drug for the older user. Other options should be considered before use of this compound. Dosages are on the order of 50-100 mg/d and for no more than 4 weeks.

- Halotestin provides a potent hardening effect, at least in part, through modulation of glucocorticoid signaling. There is also a significant temporary increase in strength. There is very little water retention. However, this drug is hepatotoxic, leads to high BP and negatively effects blood lipids. It is difficult to tolerate for most at more than 20 mg/d and this is sure to be no better in older users. Use should be limited to no more than 4 weeks.

Growth Hormone axis enhancement

The drugs I will discuss will be limited to somatotropin (hGH), GHRP-6 and -2, Ipamorelin, GRF 1-29 and CJC 1295DAC. There are others but these are the major compounds currently in use. Growth hormone is released in a pulsatile fashion from the pituitary gland with a major pulse occurring at night during sleep (Kasting, Martin et al. 1981; Stewart, Clifton et al. 1985). As we age we lose the magnitude and overall secretion of growth hormone. This protein is a master hormone which, once released, causes a cascade of growth factors to be released. They are collectively termed somatomdedins (Cohen and Fyffe 1980; Froesch and Zapf 1980) and include such factors as IGF-1, -2 and vitronectin. These and other hormones lead to most of the renewing processes of the body. As we age their reduced production contributes to the overall aging process as repair and renewal processes are diminished. The above compounds can be used to restore somatotropin either by replacement or by tickling the pituitary to secrete more youthful or even higher amounts of it. Some of these peptides have anti-inflammatory activity (Granado, Priego et al. 2005). Below are descriptions and suggested ways to use them.

- hGH: As described previously this is the master hormone of the body. In men the amount of somatotropin secreted a day is on the order of 1-2 iu and this dose is considered a complete replacement dose (Jorge, Marchisotti et al. 2006; Gotherstrom, Bengtsson et al. 2007). At this dose administered daily or on a 5 on 2 off schedule most older adults with deficiency report a restoration of vitality, more supple skin, better sleep, fat loss and improved muscle mass and tone. As used for performance or vitality enhancement 1-4 units is sufficient in older men. Side effects include water retention, joint pain, and carpel tunnel syndrome. It is advisable to start out at lower dose such as 1 iu/d and increase 50% of the dose every 1-2 weeks to avoid side effects. If side effects persist the dose should be lowered until tolerable.

- GHRP-6, -2 and Ipamorelin are all similar in composition and in effect (Shimatsu 2004). In addition to causing the release of GH they also can lead to the release of corticotropin and prolactin but these are transient and the intensity of release decrease in the order they are listed (Carmignac, Bennett et al. 1998). GHRP-6 is the most potent of the three for appetite. For all intents and purposes dosage is close to saturation at 100 ug but more effect can be had at bolus injections of up to 300 ug. Some internet gurus advise injection of 100ug 3 times per day. Therapeutic dose is 100-200 ug before bed/d. GHRP-2 and Ipamorelin are more active than GHRP-6 so less is more. Dosing should be on an empty stomach with no food for at least 30 minutes before or after the dose. Protein meal is OK but no carbohydrates or fats as they will inhibit the pulse.

- GRF-1-29 and CJC 1295 DAC: these are similar. The former is fast acting and performs it action and is metabolized in minutes (Losa, Schopohl et al. 1984). CJC 1295 DAC has been modified to associate with its binding protein remaining sequestered in equilibrium with the plasma stretching its active life for days (Teichman, Neale et al. 2006). It will raise the baseline level of GH secretion while allowing for pulsitile peaks to raise higher than naturally possible. Some internet gurus claim CJC1295 DAC causes GH bleed meaning that slow release of GH leads to somatotropin exhaustion and loss of effect. Others state that this is not the case. The literature appears to support the later case. GFR1-29 is used at 50-100 ug 1-3 times a day and can be used in conjunction with GHRP or Ipamorelin. CJC 1295 is dosed 1-2 times a week at 1-2 mg per dose.

Sample stacks

These stacks assume that the user is on testosterone replacement and has had a successful physical and blood work performed recently. It is advisable to donate blood every 8 weeks to offset increased RBCs. Over 15% of men over 40 will demonstrate erythrocytosis with just a replacement dose of testosterone and the risks increase with dose so we can assume that most older men are susceptible to erythrocytosis (Coviello, Kaplan et al. 2008; Bachman, Feng et al. 2010). Cycle lengths are for 8 weeks upon completion of which the user is to return to a true TRT dose of testosterone. GH and or GHRPs/GRFs can continue at therapeutic doses.

Stack 1:

Testosterone cypionate 300 mg/w

Durabolin 300 mg/w

GH 2 iu 5/2

Adex 0.5 mg EOD

hCG 250 iu EOD

Stack 2:

Testosterone enanthate 300 mg/w

Primobolin 400 mg/w

GHRP-2 200 ug before bed 5/2

Adex 0.5 mg EOD

hCG 250 iu EOD

Stack 3:

Sustanon 400 mg/w

Deca durabolin 300 mg

Ipamorelin 200 ug before bed 5/2

GRF1-29 100 ug before bed 5/2

Letrozole 0.5 mg EOD

hCG 250 iu EOD

Stack 4:

Cypionate 300 mg/w

Anavar 30-50 mg/d

GHRP-2 200 ug before bed 5/2

Adex 0.5 mg EOD

hCG 250 iu EOD

It is wise to set a series of side effect markers to observe before entering into a cycle. These could be:

1. symptoms of gynecomastia

2. water retention

3. signs of BPH

4. acne

5. changes in libido

6. excessive sweating

7. cardio vascular fitness

They can be ranked 1-10 and initially assessed before starting the stack and evaluated as the treatment progresses. If they increase significantly for instance the dose can be adjusted downward. If, for instance, 1 and 2 increase but others remain constant the AI can be increased. If 3-4 of the markers become elevated the stack can be stopped or dose decreased by ¼ to ½. If no markers change it may be appropriate to increase dose. I prefer to increase the anabolic rather than the testosterone as increased test can sometimes lead to diminished libido through conversion to estrogen or even over stimulation of the limbic system with high DHT. Decaduraboln can be tricky. hCG is helpful for presention of ED. Also 50-100 mg of Masteron is often helpful. Some swear by pramipexole, a D2 agonist but side effects for the fix itself can make more misery. It’s best to start out lower in the dosage range and adjust upward rather than be ravaged with a host of side effects and attempt to put out the fires.

Diet

This is probably the most important part of health, well being and general overall appearance. Everyone has to find the food that work to build lean mass and maintain health. For me there are essentially 15 foods which are:

Chicken breast

Tilapia/tuna

Lean ground beef

Whey isolate

Eggs/egg whites

Basmati rice

Potatoes

Sweet potatoes

Broccoli

Peas

Carrots

Olive oil

Almonds/cashews

Occasional fruit is OK

It’s difficult to put on a lot of fat if you stick to these food stuffs. The diet should consist of 4-6 meals a day of 300-800 calories per sitting. Protein intake is paramount and should be 1-1.5 grams/lb of body weight. For those that are carbohydrate sensitive I would recommend no more than 1-1.25 grams per lb body weight. For a 200 lb man that is approximately 900 + 900 = 1800 cals. On a typical 3000 cal diet that leaves approximately 130 grams of fat. Once dialed into a calorie count you will know what macros work best for you and what maintenance cals you need. To drop body fat decrease fat and carbs. Always keep protein high. Protein will convert to glucose and the carbon skeletons of fats are important for many lipid components on the body especially important in CNS function. Carbohydrates are somewhat dispensible since we have glycogen synthesis in the muscle and liver issues, wihich leads to stable blood glucose levels in the healthy person.

References

Bachman, E., R. Feng, et al. (2010). "Testosterone suppresses hepcidin in men: a potential mechanism for testosterone-induced erythrocytosis." J Clin Endocrinol Metab 95(10): 4743-4747.

Berger, J. R. (2000). "Resistance exercise and oxandrolone for men with HIV-related weight loss." JAMA 284(2): 176; author reply 177.

Berger, J. R., L. Pall, et al. (1996). "Oxandrolone in AIDS-wasting myopathy." AIDS 10(14): 1657-1662.

Bozzini, C. E. and R. M. Alippi (1971). "The erythrogenic effect of steroids with predominant anabolic or androgenic activity in the polycythemic mouse." Horm Metab Res 3(1): 52-54.

Burge, J. J. (1983). "C1-inhibitor deficiency (hereditary angioedema): case report and review." Va Med 110(12): 706-711.

Carmignac, D. F., P. A. Bennett, et al. (1998). "Effects of growth hormone secretagogues on prolactin release in anesthetized dwarf (dw/dw) rats." Endocrinology 139(8): 3590-3596.

Cicardi, M., R. Castelli, et al. (1997). "Side effects of long-term prophylaxis with attenuated androgens in hereditary angioedema: comparison of treated and untreated patients." J Allergy Clin Immunol 99(2): 194-196.

Cohen, H. N. and J. A. Fyffe (1980). "Somatomedins and other serum growth factors: a review of current concepts." Scott Med J 25(1): 50-57.

Coviello, A. D., B. Kaplan, et al. (2008). "Effects of graded doses of testosterone on erythropoiesis in healthy young and older men." J Clin Endocrinol Metab 93(3): 914-919.

Delgado, J., A. Saborido, et al. (2010). "Prolonged treatment with the anabolic-androgenic steroid stanozolol increases antioxidant defences in rat skeletal muscle." J Physiol Biochem 66(1): 63-71.

Froesch, E. R. and J. Zapf (1980). "[Growth factors with identical insulino-situations : IGF I and II, NSILA and somatomedins (author's transl)]." Ann Endocrinol (Paris) 41(6): 502-511.

Gorshein, D., S. Murphy, et al. (1973). "Comparative study on the erythropoietic effects of androgens and their mode of action." J Appl Physiol 35(3): 276-278.

Gotherstrom, G., B. A. Bengtsson, et al. (2007). "Ten-year GH replacement increases bone mineral density in hypopituitary patients with adult onset GH deficiency." Eur J Endocrinol 156(1): 55-64.

Granado, M., T. Priego, et al. (2005). "Anti-inflammatory effect of the ghrelin agonist growth hormone-releasing peptide-2 (GHRP-2) in arthritic rats." Am J Physiol Endocrinol Metab 288(3): E486-492.

Grunfeld, C., D. P. Kotler, et al. (2006). "Oxandrolone in the treatment of HIV-associated weight loss in men: a randomized, double-blind, placebo-controlled study." J Acquir Immune Defic Syndr 41(3): 304-314.

Harman, S. M. (2005). "Testosterone in older men after the Institute of Medicine Report: where do we go from here?" Climacteric 8(2): 124-135.

Jentsch-Ullrich, K., S. Leuner, et al. (1998). "[Angioedema caused by C1 esterase inhibitor deficiency]." Dtsch Med Wochenschr 123(23): 737-740.

Jorge, A. A., F. G. Marchisotti, et al. (2006). "Growth hormone (GH) pharmacogenetics: influence of GH receptor exon 3 retention or deletion on first-year growth response and final height in patients with severe GH deficiency." J Clin Endocrinol Metab 91(3): 1076-1080.

Kasting, N. W., J. B. Martin, et al. (1981). "Pulsatile somatostatin release from the median eminence of the unanesthetized rat and its relationship to plasma growth hormone levels." Endocrinology 109(5): 1739-1745.

Losa, M., J. Schopohl, et al. (1984). "Stimulation of growth hormone secretion with human growth hormone releasing factors (GRF1-44, GRF1-40, GRF1-29) in normal subjects." Klin Wochenschr 62(23): 1140-1143.

Shimatsu, A. (2004). "[Ghrelin-related drugs: clinical perspectives]." Nippon Rinsho 62 Suppl 9: 435-438.

Sloane, D. E., C. W. Lee, et al. (2007). "Hereditary angioedema: Safety of long-term stanozolol therapy." J Allergy Clin Immunol 120(3): 654-658.

Stewart, J. K., D. K. Clifton, et al. (1985). "Pulsatile release of growth hormone and prolactin from the primate pituitary in vitro." Endocrinology 116(1): 1-5.

Teichman, S. L., A. Neale, et al. (2006). "Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults." J Clin Endocrinol Metab 91(3): 799-805.

Townsley, J. D. and H. J. Brodie (1970). "Low conversion of 19-nortestosterone to urinary oestrogens." Lancet 2(7681): 1039.