A warning has been issued about the use of unprescribed steroids after two young male bodybuilders were admitted to a Limerick hospital suffering from heart failure following their use.
The men, who presented within seven days of each other, with severe dilated cardiomyopathy first told doctors they had used a nutritional supplement purchased at a trade show four weeks earlier.
As a result, an in-depth investigation took place to see if the nutritional supplement could have contributed to their condition. However, an analysis of the supplement at the State Laboratory in Celbridge, Co Kildare ruled this out.
When the patients were interviewed they also revealed they had been taking steroids and Dr Fionnuala Donohue, a public health specialist with the Health Service Executive (HSE) in the midwest, said a search of the medical literature was conducted.
Steroids were reported in the literature as having cardio-toxic effects and as being linked to cardiomyopathy, although it could not be clinically proven in the cases of the two patients who presented that their heart conditions were linked only to their use of steroids.
It was decided, she said, to contact all cardiologists in the Irish medical directory to see if they had come across any similar cases. One-quarter of all cardiologists responded to the survey and 43 per cent reported seeing cardiomyopathy in young bodybuilders over the previous one to three years. They included a third Limerick case in the previous two months which had not already been known to the researchers.
All the cardiologists reported anabolic steroid use by these patients. Some had also used other drugs including insulin and growth hormones.
Dr Donohue said studies of users of anabolic steroids had shown the majority of users obtain them on the black market and experience side effects after their use, but still continue using them.
However, she said there was no Irish data on prevalence of anabolic steroid use in the Republic.
"A prospective study of dilated cardiomyopathy in young males in Ireland is recommended as a sentinel approach towards assessing the impact of an emerging public health threat where formal information on substance use may be limited," she said.
The occurrence of three cases of dilated cardiomyopathy in males under 40 years within a two-month period was above the expected incidence for the Limerick area, she said.
The hospital attended by the men or exact timeframe of their presentation cannot be published in order to protect their identities. It is understood they are continuing to attend cardiologists.
The study was presented at the summer scientific meeting of the faculty of public health at the Royal College of Physicians of Ireland.