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What Are IPEDS: Risks and Side Effects

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May 30, 2023

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Image and Performance Enhancing Drugs (IPEDs) are substances or medications used to improve physical appearance, athletic performance, or muscle strength. These drugs are often associated with the realm of competitive sports, bodybuilding, and aesthetic enhancement.

IPEDs can be broadly categorised into three main types:

Anabolic Steroids: Anabolic steroids are synthetic derivatives of the male hormone testosterone. They promote muscle growth, increase protein synthesis, and enhance athletic performance. Anabolic steroids are commonly used to gain muscle mass, improve strength, and reduce body fat. However, they also carry numerous health risks, including cardiovascular problems, liver damage, hormonal imbalances, and psychological effects.

Peptide Hormones and Growth Factors: This category includes substances such as human growth hormone (HGH), insulin-like growth factor-1 (IGF-1), and erythropoietin (EPO). Peptide hormones stimulate muscle growth, aid in recovery, and enhance endurance. However, misuse of these substances can lead to serious health complications, such as organ enlargement, diabetes, and increased risk of certain cancers.

Stimulants and other Performance Enhancers: This group encompasses substances like amphetamines, clenbuterol, and diuretics. Stimulants increase energy, reduce fatigue, and improve focus. Diuretics are often misused for their ability to cause rapid water loss, leading to temporary weight loss and increased muscle definition. However, these drugs can have detrimental effects on cardiovascular health, mental well-being, and electrolyte balance.

There is no possession offence but it is illegal to manufacture, supply or possess/import/export steroids with the intent to supply, without a licence to do so.

IPEDs, in the context of sport, are substances banned by the World Anti-Doping Agency (WADA), as per the Prohibited List which is updated and published on an annual basis.

It’s really important to understand that these powerful medications can have serious consequences on your health.


There are numerous types of IPEDs, each with their own unique risks. The most popular types of IPEDs include Testosterone, anabolic steroids, human growth hormone (HGH), and hormone analogues.


As men age, their testosterone levels decline, which can be treated by testosterone replacement therapy (TRT). TRT is designed to help increase your testosterone to ‘normal’ levels and can be helpful in maintaining athletic and sports performance in older men. However, using TRT or testosterone products without prescription or low testosterone levels can be dangerous.

Side Effects:
TRT and testosterone gels/creams have a long list of side effects. You may experience breast enlargement, acne, depression, reduced libido, headaches and diarrhoea. More serious side effects include nausea or vomiting, sleep apnoea, chest pain and in some cases, where there is prolonged use, heart disease and strokes[1].

Legal Status:
TRT can be prescribed by your doctor if you’re suffering from low T-levels.


Anabolic Steroids are synthetic hormones that athletes inject or consume orally. They help to stimulate muscle growth and improve an individual’s strength by replicating the effects of testosterone. While they can lead to increased muscle mass and strength, they can also cause a wide range of side effects and health risks.

Side Effects:
Some of the most common side effects of steroid abuse include acne, hair loss, and mood swings, while more serious risks include liver damage, cardiovascular disease, and infertility. Additionally, anabolic steroid use can also lead to psychological addiction and withdrawal symptoms. Due to the potential risks and side effects, the use of anabolic steroids should be carefully monitored and only used under the guidance of a medical professional.

Legal Status:
Anabolic Steroids are a class C drug, which means they can only be issued by a pharmacist. It is legal to have anabolic steroids for personal use, and it is illegal for them to be shipped or posted by a courier service. It is also illegal to possess anabolic steroids if it’s believed you’re going to sell or distribute them, including giving them to your friends. You could face an unlimited fine and jail time if you break the law[2].


HGH is a protein that is produced naturally in the body and helps to regulate growth and development. Athletes use HGH to stimulate muscle growth, improve strength, and reduce the risk of injury.

Side Effects:
HGH is naturally produced in the body, but when taken in excessive amounts, it can lead to a condition known as acromegaly[3], which causes the bones in the face, hands, and feet to thicken and enlarge. Other side effects of HGH abuse include joint pain, muscle weakness, high cholesterol levels, and an increased risk of cardiovascular disease. HGH abuse can also lead to insulin resistance and type 2 diabetes[4].

Legal Status:
HGH is considered a controlled substance, and is illegal for personal use, such as body building[5].


EPO is a hormone that stimulates the production of red blood cells in the body. It is used by athletes to increase their endurance and stamina, as red blood cells transport oxygen to the muscles.

Side Effects:
The use of EPO can have serious side effects, including an increased risk of blood clots, stroke, and heart attack.

Legal Status:
Erythropoietin (EPO) is illegal to own in the UK without medical justification. They are also illegal to sell and administer to others[6].


Selective androgen receptor modulators (SARMs) are experimental drugs that are similar to anabolic steroids, but are designed to be more selective in their action. They work by binding to androgen receptors in the body, which can lead to increased muscle mass, strength, and performance. They were originally designed to be used for patients suffering with muscle atrophy or wasting disease.

Side Effects:
Using SARMs can have a range of side effects and health risks. Some of the most common side effects include acne, hair loss, an increased risk of cardiovascular disease and liver failure[7]. SARMs can also interfere with natural hormone production, leading to infertility and sexual dysfunction. In women. They can cause a disruption to the menstrual cycle, as well as causing pain, swelling and unwanted hair growth. Additionally, SARMs are not approved for human use and are often sold illegally, making it difficult to know the purity and dosage of the product. As a result, using SARMs can be very dangerous and should be avoided.

Legal Status:
The law around SARMS is complicated. They are illegal to sell for human use in the UK, but are not illegal to buy or use.


Diuretics are drugs that increase urine production and are often used to treat conditions such as high blood pressure and oedema. However, they are also sometimes used by athletes and bodybuilders to quickly lose weight and improve muscle definition.

Side Effects:
While diuretics can be effective at reducing water weight, they can also have a range of side effects and health risks. Common side effects include dehydration, electrolyte imbalances, and muscle cramps. More serious risks include kidney damage, liver damage, and an increased risk of cardiovascular disease. Additionally, diuretics can lead to rebound water weight gain, making it difficult to maintain a lean physique. Due to the potential risks and side effects, the use of diuretics for weight loss or muscle definition should be avoided and only used under the guidance of a medical professional.

Legal Status:
Diuretics are legal to buy and use in the UK. You can get diuretics via prescription and over the counter.


The use of PEDs may provide athletes with a competitive edge, but it can have serious consequences on their health. The risks and side effects associated with PED abuse can be debilitating and potentially life-threatening. Athletes who use PEDs not only jeopardise their health but also their reputation and their sport’s integrity. It is crucial to understand the risks associated with the use of PEDs and maintain clean and fair sporting events.

The use of IPEDs is associated with various risks and potential side effects. These may include adverse physical effects, psychological dependence, social consequences, legal issues, and damage to long-term health. IPED use can impact multiple organ systems, including the cardiovascular, endocrine, hepatic, and musculoskeletal systems.

The use of IPEDs without medical supervision or for non-medical purposes is generally considered illegal and against the regulations of many sports organisations. Anti-doping agencies, sports federations, and health authorities actively monitor and enforce policies to deter the misuse of IPEDs in sports.

It is essential to prioritise health and well-being over the pursuit of short-term gains. Engaging in safe and legal training practices, maintaining a balanced diet, seeking professional guidance, and focusing on natural and sustainable methods of performance enhancement are crucial for athletes and individuals seeking to improve their physical appearance.

Despite their questionable status in UK law, use is widespread in UK gyms. The most common demographic for steroid use was males aged 20 – 24. Research for UKAD’s Clean Sport Week 2019 found that a third (34%) of UK gym users surveyed said they were aware of other members of their gym taking IPEDs while nearly a sixth (14%) knew someone suffering from the effects of IPED use[8].

Did you know?

34% of UK gym users said they were aware of other members of their gym taking IPEDs

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As a health and wellbeing company, our first and foremost focus is ensuring everyone is using a food first approach alongside regular, enjoyable exercise to maximise their health. However, we also want to provide a service for those who are not being well serviced by traditional NHS services.

To that end, in 2010 the UK Government via Advisory Council on the Misuse of Drugs (ACMD) recommended that there should be a greater emphasis placed upon education and support. With this in mind we have elected to adopt a harm reduction approach to individuals who are using IPED without prejudice.

Harm reduction is a vital approach when it comes to addressing the health risks associated with the use of Image and Performance Enhancing Drugs (IPEDs). Harm reduction recognises the reality that some individuals will continue to use these substances despite legal and health-related consequences. Rather than focusing solely on eliminating drug use, harm reduction aims to minimise the negative consequences and promote safer practices. We aim to support this through regular blood testing.

Medically Reviewed

Dr Thom Phillips

This article has been reviewed by our medical expert

Our expert Dr Thom Phillips works in NHS general practice and has a decade of experience working in both male and female elite sport. He has a background in exercise physiology and has published research into fatigue biomarkers.