5 Ways Building Muscle Increases Your Chances Of Survival
How can building muscle increase your chances of survival? Many people in developed countries have an inherent fear about not being feeling prepared for situations where they no longer have the protective blanket that modern civilization provides. In response, some choose to stock up supplies, some buy arms, others do their best to learn as much as they can about living off the land. Immersing themselves in the traditions of our non so distant ancestors who lived in a world bereft of our modern conveniences. I myself have studied and taught survival courses for decades, while being very aware that the likelihood of my needing to hunt, build shelters, find food, water and defend myself and my family during a societal collapse is very, very small. It’s an invaluable skill set, and I strongly believe that everyone should have these skills as there is no downside to knowing how to take care of yourself. But to be quite frank, the most important asset that most of us will need for survival during the course of our lives isn’t knowing how to put meat on the table, nor is it any special multi-tool that can do everything from cutting wires to making you coffee, it’s muscle. Lean muscle mass to be precise. Unlike some of the aforementioned skills, you don’t need to be faced with a zombie apocalypse to have cause to rely on lean muscle mass to save your life, as almost all of us will eventually be faced with unfortunate circumstances where the amount of lean muscle mass on our bodies may spell the difference between life and death. War is an unfortunate part of our human existence and we see all too easily how war can displace millions from the relative security of modern life. Putting men and women who before lead very ordinary lives in extraordinary situations where starvation, injury, illness and incredible physical effort becomes the norm. In this article we will explore how muscle mass protects and has protected us for millions of years in the harshest of environments and circumstances in ways that might not readily come to mind. Certainly having more muscle would make it easier to walk, climb and lift- all important components of survival, but there are several other benefits as we will see. We will also highlight the need for clinical recommendations of muscle building resistance exercise, as building muscle is far more effective at improving quality of life and survival rates than aerobic centered exercises. Thank you for taking the time to read my work and please share it with anyone who you think might find it to be of interest.
5 Ways Building Muscle Increases Your Chances Of Survival
- Muscle Mass Extends Survival During Periods of Starvation
- Muscle Mass Increases Survival Rates From Severe Injuries
- Muscle Mass Helps Recovery From Injury
- Muscle Mass Might Increase Rates Of Survival From Cancer and Chronic Disease
- Muscle Mass Helps Prevent Injuries & Keeps You From Being Dependent On Others For Survival
Muscle Mass Extends Survival During Periods of Starvation
When most of us in the developed part of the world think of situations where starvation may occur, we think of food shortages due to some form of societal collapse. As much as this image of having to fend for yourself in a world without supermarkets might easily come to mind, we are far more likely to face starvation as a result of far more mundane circumstances. Being lost, trapped or imprisoned in an environment without food is not an uncommon occurrence and can happen to anyone in any part of the world. Survival under the duress of food scarcity is, as we will see directly correlated to muscle mass. Any major reduction in the protein content of our major organs, skin, brain, heart and liver can be fatal.[5] When we eat, tissues from these organs receive a steady supply of amino acids from our bloodstream, which is used to maintain a balance between the continuous cycle of protein breakdown and synthesis that occurs in all tissues. When there isn’t any food, the protein in our muscles that act as the main source of amino acids for these important organs, (think of muscle mass as our bodies’ natural protein reservoirs.) [1,2,3] If there is no food intake for prolonged periods, muscle protein can also be used by the liver to synthesize glucose, the fuel required for our brains and muscles to function in a process called gluconeogenesis.[4] That said, the protein mass of our essential organs and the necessary blood glucose levels for continued functioning can be sustained at relatively constant levels without food as long as body muscle mass levels are able to supply the required amino acids.[5]
There is a common perception that in a situation where food supplies are low or nonexistent that an overweight person would be in a better position than a lean and well muscled man or woman, and while it would seem to make sense that someone with greater fat stores would do better in a famine situation, the biology of how our bodies react to the scarcity of food shows otherwise.[5] We have evidence from starvation studies conducted in the 1960’s that found obese individuals were able to maintain normal levels of plasma amino acids after 60 days or more of complete fasting.[6] Now before you conclude that their increased body fat was the reason, it should be noted that obese individuals in general tend to have higher than normal muscle mass, as their bodies need larger muscles in order to move a heavier overall body.[5] As such, it was their higher than normal muscle mass that accounted for the ability of overweight individuals in this group to be able to maintain normal amino acid concentrations despite weeks of not eating.
In fact, studies of AIDS patients and observations made by physicians during World War II in the ghettos of Europe, suggest that depletion of muscle mass is the cause of death during human starvation.[7,8,9] Consequently, a lean and muscular man weighing 220 lbs would in theory survive longer than an obese man who weighed the same. While it might also sound somewhat counter-intuitive, the protein requirements of well muscled men and women decrease over time (See my article- How Much Protein Do You Really Need) so they would not need enormous amounts of protein to survive. Please note though that when I say “well muscled” men and women, I am referring to individuals who are naturally muscular or those who built their physiques naturally without the use of anabolic steroids and performance enhancing drugs. Individuals who build hyper-muscular bodies using anabolic steroids facing extreme conditions where food is limited to the point of starvation might not benefit much from their added muscle mass as we would assume that drugs would not be readily available and sudden discontinuation of high-dose or long-term anabolic steroid use results in abnormally rapid decreases in muscle mass. Steroids are essentially synthetic derivatives of the male hormone testosterone, which among other things is responsible for maintaining muscle mass and muscle growth. When steroid use continues at bodybuilding-type doses for prolonged periods of time, the exogenous hormones suppress the hypothalamic-pituitary-testicular (HPT) axis, which regulates testosterone secretion by determining how much circulating testosterone there is in the body at any given point in time. If levels fall below a certain point, more testosterone is secreted and if levels are higher than normal, as in the case of anabolic steroid use, endogenous testosterone is completely stopped, and may take weeks, months, years or never resume without the use of other interventions.[24,25,26] Leaving the user hypogonadal and prone to weakness fatigue and other symptoms of endocrine dysfunction.[21,22,23] Given the severe withdrawal brought on by the cessation of such drugs, in a hostile situation, those dependent on anabolic steroids might be severely disadvantaged without continued drug access, regardless of how much muscle mass they are carrying.[21] On the other hand, those training without using any kind of anabolic drugs, would maintain significant amount of muscle mass and strength even if they stopped weight training. See my article What Happens When You Stop Weight Training
Muscle Mass Increases Survival Rates From Severe Injuries
When someone is severely injured it is a commonly held notion that their being strong willed somehow increases their chances of survival. As comforting as this trend of thought might be, studies are mixed on whether optimism and willpower really makes a difference in predicting survival outcomes, whereas physical attributes, such as significant muscle mass, correlate strongly with increased rates of survival from life threatening injuries.[5] The stress of a traumatic injury or severe infection increases our bodies’ demand for amino acids from muscle protein stores even more so than from fasting.[10] This increase in protein breakdown is directly related to the severity and duration of the injury sustained and in order to recover, our bodies will increase the synthesis of specific proteins involved in the healing of wounds. And the amino acid requirements to synthesize these proteins is extremely high. Studies of wound healing reveal that a protein intake of more than 3 grams of protein per kilogram of body weight is needed to heal a burn injury to half of the body.[11] Add the increased need for amino acids for liver tissue and immune cells during injuries and protein requirements may exceed 4 grams of protein per kilogram of body weight. Which, in perspective is more than double the large protein intakes regularly consumed by bodybuilders. (See my article on Protein Requirements For Muscle Building)
Net protein turnover due to injury can result in an increase in urinary nitrogen of up to 30 grams a day, which indicates that the is in a catabolic state where proteins are being broken down faster than it can be synthesized into new tissue. That said, someone who is severely injured and in a situation where they do not have access to food would lose 15% of their total body mass in 10 days, with death coming after excessive amounts of protein is lost. As a result, individuals with limited muscle mass tend to have lower recovery and survival rates than those with more muscle mass when there is a serious traumatic injury or burn.[5,13] Even if an individual with lower muscle mass drastically increased their protein intake it would not completely compensate for the protein losses brought on by the stress of a severe injury.[10] Under physical stress the reservoirs of protein in skeletal muscle and not proteins from dietary intake become the main supply of amino acids for our bodies.[12] So what matters most is how much muscle you have on your body before the injury occurs.
Muscle Mass Helps You Recovery From Injury
Surviving an injury is only part of the equation as it is equally important that you sufficiently recover from the trauma. Here in the West, individuals with serious injuries or critical illnesses tend to be confined to hospitals and hospices and so many of us in relatively good health don’t see on a regular basis just how devastating a critical illness or injury can be unless a loved one is afflicted. Studies show that less than half of all employed patients entered into intensive care units make it back to work within the first year of being discharged.[15] The substantial loss of muscle mass and the consequent loss of strength that occurs during periods of physical stress and prolonged inactivity can be debilitating, and unfortunately, if you had limited muscle mass to begin with, any subsequent loss of muscle mass could mean that a full recovery might never be possible.[5] At some point, almost everyone reading this article will face a serious illness or injury and the importance of muscle mass in being able to recover from these circumstances cannot be understated.[5] We often see the spiral towards a premature demise among the elderly who are unable to fully recover from an injury or fall, and limited muscle mass among older men and women is largely to blame. But this reality extends to people of all ages. The young girl trying to emulate the supermodel skinny fat look and the young man content that he is slim with little regard to muscle mass as an important aspect overall health.
Muscle Mass Might Increase Rates Of Survival From Cancer and Chronic Disease
Increased muscle mass not only gives you a higher probability of survival in cases of severe injuries, infections and burns but it may also play a role in increasing survival rates from cancer and cardiovascular disease.[5] Diseases that together account for well over half the adult deaths in the United States and most developed countries.[17] Both cancer and cardiovascular disease bring about accelerated and extensive loss of muscle mass, muscle strength and metabolic function, as they both exert physical stresses on the body that increases net protein breakdown just as in cases of trauma, infections and burns. Similarly with cancer and heart disease, research suggests that the amount of muscle lost and the amount of muscle retained is a strong determining factor as to whether or not the patient survives.[14,16] In studies of lung cancer patients receiving radiation therapy, the patients’ level of muscle mass, (as measured by vivo neutron-activation analysis), correlated directly with recurrence and survival rates. Those who were able to maintain or increase their muscle mass during therapy had higher rates of survival and lowered incidences of cancer returning when compared to those who lost muscle mass during treatment.[14] Remarkably, even though strong links between survival rates and muscle retention exist, there is a lack of studies examining this relationship further.[5] We know that reduced appetite is a common side effect of cancer related therapies, which in and of itself can lead to decreases in muscle mass if dietary intake is curtailed. (As we outlined in the section on muscle mass and starvation.)
On that basis alone it is not inconceivable that one day weight training with the aim of increasing muscle mass may become a clinical recommendation for those suffering from cancer to offset the loss of muscle mass that comes with the disease and the treatments. It is a natural intervention with little to no risk of adverse side effects as long as the individual is medically cleared to train and I have personally worked with several clients while they underwent radiation and chemotherapy. It was not always easy, but they all credit their weight training sessions as being an aide, even if only mentally, in getting through their treatment and thankfully they all had positive outcomes.
Muscle Mass Helps Prevent Injuries & Keeps You From Being Dependent On Others For Survival
One of the greatest gifts of having significant lean muscle mass is that it helps prevent the occurrence of injuries . Life exposes us to all manner of physical insults, (often in the in the most comfortable of environments), in the way of back strains, twisted ankles, sprained tendons and broken bones. Injuries that may seem minor, but under adverse circumstances where medial care and assistance from others is absent, many of them can be unquestionably fatal. A well muscled body reduces the likelihood of these common happenstances and as we mentioned earlier in the article, help in the recovery process as well. As you get older, if you are not engaged in activities such as resistance training, there is a natural loss of muscle over time, a process called sarcopenia. This progressive loss of muscle mass and muscle strength accelerates in middle age and continues until the end of life.[18,19] The more muscle mass you lose the less muscle function and balance you will have which can have a devastating effect on quality of life and your ability to perform everyday tasks. (See my article- The Anti Aging Properties of Weight Training & How It Reverses The Aging Process)
The problem is that if you started as a young man or woman with little muscle mass to begin with, you are more likely to be affected by sarcopenia as you age and more likely to experience falls, develop frailty and have difficulty, if not lose the ability to live independently.[20] We don’t like to think about it but the end result of losing significant muscle mass is institutionalization, or a situation where you are heavily reliant on others for survival. Intervention in the way of a muscle building resistance exercise is thus critical in the middle or younger ages of life in order to offset the effects of sarcopenia later on. Anyone serious about being able to survive in a hostile world needs to take this point seriously, as the more muscle you have and the more exercise you do to build and maintain muscle, correlates strongly with what your life will be, not only when you get older, but in situations where you have to fend for yourself. The goal being to be strong enough to effortlessly carry out the necessities of modern daily life, while also being strong enough to deal with any extraordinary circumstances if they were to occur.
Muscle Building Needs To Be Promoted More By The Medical Community
Public education regarding the importance of exercise regimes that incorporate muscle building resistance exercises is clearly needed and in the medical community, there is a lack of focus regarding recommending muscle building exercises which needs to be changed given the benefits.[5] Women naturally have less muscle mass than their male counterparts and suffer the most as a result of muscle loss as they get older. They are also the least likely to train with weights as even today, many women hold on to the myth that weight training will endow them with oversize muscles that will make them look like a man. Which is physiologically impossible in a woman with normal hormonal levels without extreme amounts and long term use of anabolic steroids. (See My Article- Should Women Lift Weights Like Men) Even many men hold this notion that lifting weights will make you big and bulky, which is understandable given that most of the general population is completely unaware of what a natural physique looks like on a man or woman since so many popular athletes, actors, fitness and social media figures associated with lifting weights use some form of drug to enhance their appearance while claiming to have developed their bodies naturally. It creates a rather skewered perception of what lifting weights does to the human body and reinforces the myth that resistance training leads to over sized muscles and extreme muscularity. Which in practice, is like believing that riding like Lance Armstrong is what happens to everyone who buys a bike. It simply isn’t that simple as building muscle is a very slow process, and there are limits as to how much muscle you can add to your body regardless of how hard you train and how many protein shakes you consume. (See my article on How Muscles Get Bigger & Stronger) What lifting weights can do is make you stronger, make every day tasks much easier to perform, help you lose body fat and look better with and without clothes and increase your odds of survival and quality of life under adverse conditions and as you get older.
High Intensity Bodyweight Training: Ballistic Pushups & Dips!
This was a tough one!
Starts out with ballistic push ups (like clap pushups but without the clap as my wrist is still not 100%) nonstop for 20 reps, then all out on dips for 10 reps.
To say it was painful would be an understatement, but you just have to push through and keep on going.
Still training, hope you are too and as always, Excelsior!!! #naturallyintense
#hometraining #homeworkout #homeworkout #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #chestday #chesttraining #naturalbodybuildingtips #pushups #dips #bodyweighttraining #highintensitytrainingtips #drugfreebodybuilding #calesthenics
Kevin's Unconventional Biceps Training- 3-6 Minutes a Week!
In this video I go over my biceps training using the Naturally Intense High Intensity Training protocols that helped me go from having arms measuring 11.5 to 12 inches to 18 inches drug free!
It's an unconventional approach for certain, but it's one that's helped my arms grow and the hundreds of men and women I have trained over the past 30 plus years.
Now, my success isn't due to being genetically gifted, as it took me the better part of 11 years to get my arms up to those measurements.
Which is significant as it works and been been proven time and time again to work for the average man or woman trying to grow their arms without drugs.
It's my hope that these high intensity training protocols can help you as much as they helped me!
Click on my bio link to see the full video on my YouTube channel and thanks as always for taking the time to look at my work!!! Excelsior!!! #naturallyintense
#highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #armworkout #bicepsworkout #naturalbodybuildingtips #biceps #armtraining #highintensitytrainingtips #drugfreebodybuilding #barbellcurls
At the Lancaster Classic Day 2 Elimination Rounds Against European Champion, and World Record Holder Leo Pettersen @leo_barebow_archer
I don't talk much about it but I'm also a competitive barebow archer (surprise!) and last Saturday I had the honor of making it to Day 2 at the Lancaster Archery Classic in the Barebow Division, as I made the top 64 out of 267 competitors and had a chance to shoot with some of the greatest barebow shooters on the planet!
I didn't make it past Leo, but it was a real rush to be there and a huge thanks to my coach, Joe MyGlyn @prolinearchery for helping me get there.
Thanks as well to my good friend @sean_chan33 for all of his help from the very start, to my line buddy Aaron Shea for taking the shot and showing up to support!
My thanks as well to rob_kaufhold for putting on and promoting one of the best archery tournaments on earth!
Thanks also to to everyone who took the time to send a supporting word and I am looking forward to next year!!! #naturallyintense #barebow
#lancasterclassic #lancasterarcheryclassic2024 #lancasterarchery #archery #fitover40 #barebowrecurve #targetarchery
Dumbo, Brooklyn circa 2004
This shot was taken as part of the promotion for my Naturally Intense DVD and was about a year after my last bodybuilding competition.
It was a grueling photoshoot.
We started at about 10 am and finished around 4pm and I was completely spent, but the more we shot the sharper I looked, so we kept on going.
It's nice to look back from time to time and as tired as I was, we all had a blast!
My thanks to @stephanie_corne_artwork, @https://pulse.ly/itgnag2dec and @ftaz1 for taking the shots!!!
Thanks for watching and as always, Excelsior!!! #naturallyintense
#naturalbodybuilder #naturalbodybuilding #throwback #fifthavenuegym #5thavenuegym #drugfreebodybuilding #naturalbodybuildinglifestyle #gymlife #gymmotivation #naturalbodybuildingmotivation #bodybuilding #blackandwhite #instablackandwhite #bnw
Can You Build An Impressive Physique Training Only At Home?
Absolutely!
I stopped training in commercial gyms as of March 2020 and have been training at home ever since.
Initially I was admittedly worried that I might lose some of my gains or not make as much progress, but that certainly wasn't the case.
I've consistently continued to improve with my high intensity workouts and muscles have no idea where they are training.
As long as the criteria of adequate intensity and overload are met, there will be an adaptive response and your muscles will get bigger and stronger.
So don't worry at all about where you train, focus instead of what will be the best way for you to always be training!
Thanks for watching and as always, Excelsior!!! #naturallyintense
Kevin's Three Day Training Spilt!
For the past 33 years I have trained three times a week with Naturally Intense High Intensity Training workouts lasting 10, 15 to 20 minutes max.
It's a training split tried and testes not only in it's helping me realize my goal of becoming a successful natural bodybuilder, but it's also helped hundreds of men and women over the past three decades.
I have tested just about every possible training split imaginable and for this particular style of high intensity training, this particular grouping consistently yields fantastic results.
I hope it helps you as much as it's helped me over the years and thanks so much for taking the time to look at my work.
Keep training hard and Excelsior!!! #naturallyintense
Excelsior!!! #naturallyintense
#trainingsplit #3daytrainingsplit #threedaytrainingsplit #naturalbodybuilding #naturalbodybuilder #naturalbodybuildingvideo #naturalbodybuildingmotivation #naturalbodybuildingtips #drugfreebodybuilding #bodybuilding #highintensitytraining #highintensitytrainingtips
405 Stiff Leg Deadlift for 7 Reps! High Intensity Training.
First leg workout of the year and already pushing it!
I haven't done a stiff leg deadlift over 315lbs for about 3 years at this point, and I did my last set with 315lbs and comfortably got to 10 reps and decided I had far too much gas left in the tank and that I should go up in weight.
So I did.
I figured I might get a solid 6 reps in, but I made it to 7 and I think I could have gone on to get a full 10 reps BUT that's when good judgement prevailed.
As a bodybuilder having not trained this heavy for so many years, the shock of this much weight would be more than enough to stimulate muscle growth, and doing more reps wouldn't yield any greater returns, only increase the likelihood of injury.
It's not about the numbers, it's about training to a point where you achieve your goal, and it's important to have a goal in mind as a bodybuilder based on increasing muscle mass rather than hitting a particular number.
Besides, if in my 20's I never did more than 405lbs on a stiff leg deadlift, it doesn't make any sense going heavier than when I am almost 50!
Could I deadlift more at this point?
Absolutely but just because you can doesn't mean you should!
So keep those weights in a good working range, keep it safe and as always Excelsior!!! #naturallyintense
#hometraining #homeworkout #homeworkout #roguerack #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #backworkout #naturalbodybuildingtips #backtraining #highintensitytrainingtips #drugfreebodybuilding #fitoverforty #deadlift
Turning 50 in a few months...
Not much of a big deal for me as I still feel pretty much the same but I hope that my example helps show what can be done with a lifetime commitment to eating well and training consistently!
Thanks for coming along on the journey and as always, Excelsior!!! #naturallyintense
#naturalbodybuilder #naturalbodybuilding #healthylifestyle #fitover40 #drugfreebodybuilding #naturalbodybuildingmotivation #natty #fitness
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How Muscle Increases Survival References:
1. Cahill GF Jr. Starvation in man. N Engl J Med 1970
2. Felig P, Owen OE, Wahren J. Amino acid metabolism during prolonged starvation. J Clin Invest 1969
3. Biolo G, Zhang X-J, Wolfe RR. Role of membrane transport in interorgan amino acid flow between muscle and small intestine. Metabolism 1995
4. Felig P. The glucose-alanine cycle. Metabolism 1973
5. Wolf R. The underappreciated role of muscle in health and disease. Am Society for Nutrition 2006
6. Drenick EJ, Swendseid ME, Bland WH, Tuttle SG. Prolonged starvation as treatment for severe obesity. JAMA 1964
7. Kotler DP, Tierney AR, Wang J. The magnitude of body cell mass depletion determines the timing of death from wasting in AIDS. Am J Clin Nutr 1989
8. Winick M. Hunger disease. Studies by the Jewish Physicians in the Warsaw Ghetto. New York, NY: Wiley & Sons, 1979
9. Keys A, Brozek J, Henshel A, Mickelsen O, Longstreet TH. The biology of human starvation. Minneapolis, MN: University of Minnesota Press, 1950.
10. Biolo G, Flemming RYD, Maggi SP, Nguyen TT, Herndon DN, Wolfe RR. Inverse regulation of protein turnover and amino acid transport in skeletal muscle of hypercatabolic patients. J Clin Endocrinol Metab 2002; 87: 3378–84. CrossRefMedline
11. Zhang X-J, Chinkes DL, Wolfe RR. The flow phase of wound metabolism is characterized by stimulated protein synthesis rather than cell proliferation. J Surg Res (in press).
12. Jan BV, Lowry ST. Systemic response to injury and metabolic support. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE, editors. Schwartz’s Principles of Surgery. 9th ed. New York: Mc Graw-Hill; 2010.
13. Pereira CT, Barrow RE, Sterns AM, et al. Age dependent differences in survival after severe burns: a unicentric review of 1674 patients and 179 autopsies over 15 years. J Am Coll Surg 2005
14. Kadar L, Albertsson M, Arebert J, Landbert T, Mattsson S. The prognostic value of body protein in patients with lung cancer. Ann N Y Acad Sci 2000
15. Bams JL, Miranda DR. Outcome and costs of intensive care. Int CareMed 1985
16. Anker SD, Steinborn W, Strassburg S. Cardiac cachexia. Ann Med 2005
17. Anderson RN, Smith BL. Deaths: leading causes for 2002. National Vital Statistics reports. Vol 53. Hyattsville, MD: National Center for Health Statistics, 2005
18. Holloszy JO. The biology of aging. Mayo Clin Proc 2000
19. Balagopal P, Royackers OE, Adey DB, Nair KS. Effects of aging on in vivo synthesis of skeletal muscle myosin heavy-chain and sarcoplasmic proteins in humans. Am J Physiol Endocrinol Metab 1997
20. Evans WJ. What is sarcopenia? J Gerontol A Biol Sci Med Sci 1995
21. Medraś M, Tworowska U. Treatment strategies of withdrawal from long-term use of anabolic-androgenic steroids. Pol Merkur Lekarski. 2001
22.Reyes-Fuentes A, Veldhuis JD. Neuroendocrine physiology of the normal male gonadal axis. Endocrinol Metab Clin North Am. 1993
23. Swerdloff RS, Wang C, Hikim APS. Hypothalamic-pituitary-gonadal axis in men. In: Pfaff D, Arnold A, Etgen A, Fahrbach S, Rubin R, editors. Hormones, Brain and Behavior. vol 5. San Diego: Elsevier. 2002
24. Boyadjiev NP, Georgieva KN, Massaldjieva RI, Gueorguiev SI. Reversible hypogonadism and azoospermia as a result of anabolic-androgenic steroid use in a bodybuilder with personality disorder. A case report. J. Sports Med. Physical Fitness. 2000
25. Menon DK. Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. Fertil. Steril. 2003
26. van Breda E, Keizer HA, Kuipers H, Wolffenbuttel BH. Androgenic anabolic steroid use and severe hypothalamic-pituitary dysfunction: a case study. Int. J. Sports Med. 2003
