In conclusion, one can fairly say that the lean BMI or body weight of modern professional top bodybuilders is about 40% higher solely as the result of massive use of very potent hormonal drugs such as androgenic-anabolic steroids, human growth hormone, IGFs, and insulin. This is more or less consistent with the observation of nowadays natural bodybuilding contests, where the BMI-values of the champions are rather close to 25 than 30. It is therefore fair to say that today's top heavy weight bodybuilders have more than half of their lean muscle mass thanks to the drugs, rather than hard training and good nutrition. No, the steep increase of lean muscle mass among top bodybuilders since the 90's has nothing to do with better genes, better training, better nutrition or supplements. Unfortunately Ronnie Coleman does not come from another planet, as many of his fans would like to believe.
All bets are off the table when high-dose testosterone and its many metabolites are used illegally, such as with anabolic steroid abuse. Strokes, embolisms, and cardiovascular disease are all more likely, as is sudden death, and liver and kidney disease. 44 In women, acne, irreversible deepening of the voice, baldness, increased facial hair, enlarged sex organs, breast reduction, depression, and infertility have all been reported. In adult men that abuse anabolic steroids, acne, baldness, permanent infertility, gynecomastia, loss of libido, erectile dysfunction, testicle shrinkage, and profuse sweating are all reported side effects. Increased testicular cancer hasn't been reported, though. 45,46