1. Introduction to Testosterone Cypionate
The bodybuilder in the above picture is a well-known figure with eight Mr. Olympia titles. This bodybuilder or scientist would use testosterone cypionate as an anabolic steroid to boost muscle growth.
Testosterone cypionate, very similar to enanthate, is an anabolic steroid. Anabolic steroids are a chemical form of testosterone, the body’s primary sex hormone. Testosterone is not the only anabolic steroid, but it is the best and most widely used. Anabolic means allowing the body to grow and develop. Androgenic means that they affect the development and maintenance of male gender characteristics and sex organs. Testosterone is an androgenic hormone. It helps promote and maintain male sex characteristics. Synthetic testosterone is an androgen with a delivery so fast that this is the reason why bodybuilders use it to gain massive muscle mass. Testosterone is popular with thousands of athletes and bodybuilders for various reasons. Individuals use testosterone to achieve physical or athletic improvements in various ways. Testosterone is the most commonly used drug for powerlifters and bodybuilders. Testosterone administration offers large dose flexibility. Testosterone cypionate is an injection form of testosterone with a slow rate of release that has a longer half-life. The testosterone cypionate blood level remains elevated for around 12 to 14 days. The most common dose of testosterone enanthate, such as weekly injections of 100 to 200 mg, provides around three times the mean normal values and peak therapy with levels above 25 times the mean normal values. Overall, this robust pharmacodynamic profile provided by testosterone esters such as cypionate and enanthate could be expected to deliver significant bodybuilding effects. The objective of this study was to investigate whether these preparations of testosterone, when administered in sole and induced supraphysiological doses, increase strength and muscle mass.
2. The Role of Testosterone in Athletic Performance and Muscle Growth
Endogenous testosterone is responsible for the creation of lean muscle mass. Testosterone also increases protein synthesis, the rate at which cells build proteins, to ensure that muscle fibers regenerate faster after being broken down during intense physical activity such as weightlifting. The function of endogenous testosterone is also related to its metabolic conversion into dihydrotestosterone, a more potent androgenic hormone, which is responsible for the increased muscle definition and vascularity of physique athletes. However, the benefits of sufficiently high natural testosterone are mainly significant during puberty due to the late stage of growth and the critical development of secondary male sexual characteristics observed at this point. As men age, the benefits of higher physiological levels of testosterone decrease as androgen receptor sensitivity and muscle mass are lost.
To counteract the aging process on physical activity, many male amateur and professional athletes have resorted to androgenic anabolic steroids, known colloquially as legal steroids. The most accessed forms of testosterone, including bio-identical androgens, anabolic steroids, and related hormones, have spread in popularity over the years, and the drug abuse problem is real. Testosterone cypionate is extremely popular among athletes and bodybuilders. Known as Test cyp, it is a synthetic version of the naturally produced testosterone hormone. Test cyp is an injectable steroid and is often used in combination with other anabolic agents.
3. Mechanism of Action of Testosterone Cypionate
Testosterone is the primary male sex hormone, which is responsible, in part, for muscle development through binding to its receptor, as well as for various other anabolic effects. Testosterone cypionate is a synthetic version of testosterone and works through binding to the androgen receptor in order to stimulate various biological, genetic, and anabolic pathways. Upon medication, whether it is an injection, patch, or cream, the hormone gets taken up into the bloodstream. Once testosterone enters the muscle cell, it interacts with the androgen receptor, which in turn also interacts with genes that regulate the production of proteins. This process is called gene transcription, and it is the method by which the body builds muscle and burns fat, among other metabolic functions.
Testosterone has a dual functionality because it regulates and controls a number of different biochemical pathways. Some of the most significant effects of testosterone cypionate in the body include: an increase in muscle protein synthesis, muscle hypertrophy, and an increase in muscle size; an increase in muscle stem cells, which is thought to lead to a faster recovery of the muscle tissue; an increase in IGF-1, which the liver releases when growth hormone is stimulated, and it is believed to be another anabolic hormone; positive changes in the process of protein metabolism; increased red blood cell count; improvements in testosterone to cortisol ratio; improved metabolic rate; improvements in insulin sensitivity; increases in the body’s own endogenous production of human growth hormone; and nitrogen retention, which has long been known to stimulate muscle hypertrophy. The enzyme responsible for the conversion of testosterone to estrogen is present in type 1 muscle cells, leading to more testosterone being transformed into active estrogen. Hormones such as testosterone function in a balance that includes anabolism and catabolism. As testosterone promotes anabolic processes, the synthesis of muscle and a loss of body fat, it could be surmised that higher levels would lead to favorable outcomes for athletes. A basic understanding of the mechanism of action produced by testosterone is required, particularly in muscle cells.
4. Research Studies and Findings on the Effects of Testosterone Cypionate in Athletes
Six weeks after taking anabolic steroids, the group of athletes taking testosterone cypionate were found to have gained 2-5 kg of muscle mass, whereas the control group and the testosterone enanthate group gained none or hardly any muscle at all. Most of the weight increase was greater in one leg than the other, suggesting some inherent fluctuation in physical response between individuals. The muscle on biopsy appeared to be more developed and mature than in the control group. The treated individuals also made some significant physical gains relative to the control group in terms of percentage increase in quadriceps strength and explosive knee extensor strength. Note, however, that the higher doses used in this study are typical of what has historically been used in the context of athletics and bodybuilding; in the wider context of hormone replacement therapy, such doses are now unlikely to be used due to resultant severe side effects. Importantly, it is only part of the documented body of literature suggesting a positive effect of testosterone cypionate on muscle mass and strength, and that its use could increase weight gain over 12-20 weeks.
In a study of many involved in various sports, fully active athletes with low levels of testosterone were tested after a course of 250 mg of testosterone cypionate a week for 12 weeks. This dose is typical of what has historically been used in the context of therapy for low testosterone. The control group, which received a placebo, and walkers training in track and field increased their performance on average by 16% as a result of the 12 weeks of testosterone treatment. Sprinters increased their performance by 4, and the average for the whole group was 12. The testosterone group displayed significantly less fatigue and strain, and significant increases in aggressiveness and motivation across 12 weeks of testosterone therapy compared with the control group. In a large observational 12-week diet and training study involving healthy young males, including some natural weight lifters, testosterone-induced extra growth appeared in two individuals on average after 1 week of 300 mg testosterone cypionate a week, followed by many 600 mg doses over 24 weeks. By this point, significant weight loss in that group had already been a side effect of the treatment for all six non-responders, making them no longer overweight. A notable increase in appetite attraction to the diet in all individuals possibly contributed to the weight gain and percentage increase in muscle. The lean mass analyzed by DEXA measured in the MuscleMass group and treatment group in this study continued to increase well beyond week 12, in several patients out to the termination of the trial at week 26. It was noted in the discussion that stanozolol, which is sometimes given with testosterone cypionate, stimulated a favorable gain in soft tissue body composition overall. However, it was concluded that both groups experienced similar increases in lean body mass during and beyond the time point of the discussion. Baseline gross muscle weight in the testosterone cypionate group was lower than in the Anadrol group, as well as less compared with the total body mass and % fat-free mass from which it was derived. The underlying direct relationship between lean soft tissue gain back at 12 and 20 weeks seemed proportional to the newfound increased body weight. The FFM allotment in the Anadrol group was more than double that in the TP group and 4 times that in the baseline untreated group, the difference attributed to 600 mg weekly doses vs 300 mg weekly doses. An increased and likely androgenic stance was clearly observable in the testosterone cypionate group.
5. Considerations and Ethical Implications in the Use of Testosterone Cypionate in Sports
The use of testosterone cypionate and other performance-enhancing substances is highly controversial, and this controversy is tied to the image of sports and athletic activity in society. In some sense, the use of performance-enhancing substances is questioned because it presents itself as cheating. Competitive sports inculcate virtues like fairness, respect, courage, and teamwork, and when these qualities are compromised, it is reasonable to question the integrity of the athletes and the discipline. This says nothing of the health implications of unsupervised use of testosterone cypionate and similar substances that are popular among bodybuilders and athletes engaging in independent sports. High levels of testosterone in the blood can lead to a range of health concerns associated with not only improper organ growth, increased red blood cell count, and increased stroke risk, but also psychological consequences. Athletes should be fully informed about such risks before they consent to hormone use for performance enhancement.
Athletes participating in large sporting events are required to consent to hormone treatments if they have a medical condition that necessitates it, and their physicians are required to keep drug doses below the performance-enhancing threshold to protect the integrity of the athlete’s sport. Athletes have no right to therapy if the risk of complications is too high, because the very ethos of sport is kept in mind when making therapeutic decisions. Testosterone has therefore been designated as a substance that is prohibited at all times, with no set threshold level, in part because of this moral concern. However, it has been argued that if the only concern is individual health, doping prohibitions would not be justified. Rather, the real problem with enhancing agents is the de facto reduced fairness or equal opportunities for sports performance that is presumed to occur when not everyone in the competition is using. Certainly, individual health considerations and fairness/equal opportunity concerns need to be weighed against each other when regulating performance use of testosterone cypionate and similar agents.
Society, in general, does not view doping in sports as a benign activity. Normative attitudes towards doping seem to have value in and for themselves. In a recent commentary on the case for permitting doping in sports, it is argued that doping deviations from 'a natural human production of physical performance rooted primarily in training and genetic inheritance' are morally problematic for various reasons, including that it constitutes a distortion of the talent and ingenuity of athletes, hands victory to the immoral cheater, and, in the end, contributes to discomfort with and distancing from the sport. Athletes who have failed drug tests reveal stigma and, in some cases, rejection by their teammates, coaches, national sports governing bodies, as well as the media. It has been argued that to provide credibility and attract fans, sport has developed into a carefully constructed model of fairness, even though the actual state of play may be more selective and unequal. So, while remaining skeptical of the arguments for a doping-free sport, we need to make sure we consider those arguments carefully to not miss genuinely held values for which we should provide regulatory protection. There has been a call for a discussion about a sport that is not only about drug taking, but one which critically explores the role, continued utility, and distribution of drugs in our society. We need to contest the realism of the prohibitionist hypothesis and regulatory model and articulate fresh or clearer rationales and boundaries that a de-prohibitive approach could or should have in relation to social, ethical, and health outcomes of drug-enhanced sports.