No variation of physical performance and perceived exertion after adrenal gland stimulation by synthetic ACTH (Synacthen®) in cyclists

Abstract

There is anecdotal evidence that athletes use the banned substance Synacthen because of its perceived benefit with its associated rise in cortisol. To test the performance-enhancing effects of Synacthen, eight trained cyclists completed two, 2-day exercise sessions separated by 7-10 days. On the first day of each 2-day exercise session, subjects received either Synacthen (0.25 mg, TX) or placebo (PLA) injection. Performance was assessed by a 20-km time trial (TT) after a 90-min fatigue period on day 1 and without the fatiguing protocol on day 2. Plasma androgens and ACTH concentrations were measured during the exercise bouts as well as the rate of perceived exertion (RPE). Spot urines were analyzed for androgens and glucocorticoids quantification. Basal plasma hormones did not differ significantly between PLA and TX groups before and 24 h after the IM injection (P > 0.05). After TX injection, ACTH peaked at 30 min and hormone profiles were significantly different compared to the PLA trial (P < 0.001). RPE increased significantly in both groups as the exercise sessions progressed (P < 0.001) but was not influenced by treatment. The time to completion of the TT was not affected on both days by Synacthen treatment. In the present study, a single IM injection of synthetic ACTH did not improve either acute or subsequent cycling performance and did not influence perceived exertion. The investigated urinary hormones did not vary after treatment, reinforcing the difficulty for ACTH abuse detection.

Review of WADA Prohibited Substances: Limited Evidence for Performance-Enhancing Effects

“…However, a double-blind, placebo-controlled, crossover study in 16 trained cyclists showed that although a 1 mg ACTH depot dose decreased the feeling of fatigue during a submaximal effort, it did not improve maximal performance in a maximal exercise test, nor did it affect recovery between two consecutive tests [54]. Similarly, 20-km time-trial performance was not affected by 0.25 mg ACTH intramuscular injections in a double-blind, placebo-controlled, crossover study in eight (highly) trained male cyclists [55]. Perceived fatigue was not decreased by ACTH in this study.…”

Determination of Synacthen in urine for sports drug testing by means of nano‐ultra‐performance liquid chromatography/tandem mass spectrometry

“…Synacthen as a performance‐enhancing agent seems to possess great potential due to its various physiological effects, although there is still debate about its performance‐enhancing properties 9. Uncovering the misuse of these substance is possible only when sufficient analytical methods are available, and MS‐based methods provide well‐established data interpretation with highly specific and unambiguous results 19.…”

“…Both formulations possess a reasonable potential for misuse in elite sports that is frequently reported in the scientific literature as well as in confessions of repentant athletes and, thus, analytical methods for determination in plasma are required 8. The expected performance‐enhancing effects are mainly due to increased release of corticosteroids into circulation with well‐established benefits for performance and recovery, although the non‐existence of improvement in exercise endurance was also discussed 8, 9. Despite the option for therapeutic use exemption for athletes, the application of corticotrophins in sports without medical indication is prohibited according to the regulations of the World Anti‐Doping Agency (WADA).…”

Hormone Use and Abuse

“…An extensive review of the scientific literature performed by Duclos (Duclos, 2010b) showed two types of results: studies supporting the hypothesis that there is no relationship between performance and corticosteroid use in humans (negative studies) (Petrides et al, 1997;Marquet et al, 1999;Baume et al, 2008;Kuipers et al, 2008;Arlettaz et al, 2006Arlettaz et al, , 2008, and studies supporting the hypothesis that there are relationships between performance and corticosteroid use in humans (positive studies) (Arlettaz et al, 2007;Collomp et al, 2008;Nordsborg et al, 2008).…”