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The Millennium Science Update
The ACSM's Y2K Conference

By Dr. John M Berardi, Ph.D.
First published at www.t-mag.com, Jun 30 2000.

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What do you think of when you hear the word scientist? Pasty white beanpoles snorting with laughter at incomprehensible DNA jokes? White-coated puds wearing safety goggles who haven't seen the light of day for months and by the looks of their flabby physiques, haven't seen a set of weights since junior high when the jocks used to put chili powder in their Incredible Hulk underoos?

If that's your concept of the typical scientist you may not be far off, but just for the sake of fairness, you should show up at one of the big sports medicine/exercise physiology conferences the next time they roll into your town. You might be in for an interesting and atypical surprise.

This month, the American College of Sports Medicine, one of the most well respected "academic" organizations out there, held their annual national scientific conference at the Indianapolis Convention Center in Indianapolis, Indiana. There were several thousand scientists and science wanna-be's in attendance for the five-day extravaganza. And guess what? A good number of them actually looked like they were (gasp) in shape! Many of the male attendees were sporting some downright impressive musculature while the females … aah, the females … were tanned and fit in all of their intellectual glory!

There was even a fight between a prominent Canadian researcher and a well-known supplement supplier. The argument started over protein synthesis of all things. Actually, cooler heads intervened before things could get too ugly, but it was a very Testosterone-ish event nonetheless.

It all started during a presentation by well-known supplement researchers Dr. Jose Antonio and Dr. Jeffery Stout. Drs. Antonio and Stout were giving an enlightening lecture on dietary supplements and their role in physique and athletic enhancement, covering topics from the use of performance boosters like creatine and ribose to the use of testosterone boosters like androstenediol and Tribulis.

During the discussion some contentions made by the presenters about their belief that supplements like creatine and andro might increase the synthesis of new proteins apparently lit a small but smouldering fire under a prominent Canadian researcher's tail end. This researcher, whose name we will protect from a second public episode, fired out of his chair to inform the audience that the presenters had no data to suggest these conclusions and were just speculating about these effects. Moreover, he shared his feelings that the ACSM conference was not a place for speculation but for real scientific discussion. To understand this mindset you must realize that most scientists are trained to only believe hard data. No data, no proof. No proof, no claims. Period.

Although the feelings of the audience were mixed, one particular individual decided to speak up for "the cause." This individual, a well-known supplement supplier, jumped up and aggressively asserted that bodybuilders have successfully been using these supplements for years.

In his opinion, just because there was no hard evidence to back up the presenter's claims of effectiveness, there are real world results. In addition, he went further, perhaps too far, and attacked the Canadian personally saying that obviously he had never used creatine or any of the other compounds discussed and from the looks of him, he had never even lifted a weight in his life! Well, this ignited the place and the two verbal combatants nearly came to blows, charging each other to "discuss the science of protein synthesis" in a little more detail. Thankfully for ACSM, cooler heads prevailed and the "debate" was diffused.

Maybe next year we'll see a rematch.

Summaries and Cutting Edge Info - The Good Stuff

Although there was no bloodshed, there was quite a bit of science discussed and debated. Hundreds of sessions were held in the interest of discussing everything from the elastic structures in the foot and leg to mild traumatic brain injury; from the energy cost of Tae-bo to the passing mechanics of NFL quarterbacks; and from the effects of vitamin C on cardiovascular performance to the effects of Testosterone and prohormones on muscle mass and performance. If you ever attend one of these seminars, you'll quickly find out there are too many fascinating presentations and too little time. As a result of the meeting, over 1500 scientific studies were publicly presented, 1877 abstracts to be exact. My job has been to read them all (yes, every last one of them) in the interest of bringing T-mag readers the most cutting edge training and nutritional information available.

I've covered three main areas of interest: strength training and performance, diet and nutritional supplementation, and drugs. Since all research starts with a question, that's how I'll present the info.

STRENGTH TRAINING AND PERFORMANCE

Does one heavy set of bench press increase subsequent explosive power?

The Study: Ten males threw a 6.6 pound medicine ball as far as they could, rested 4 minutes, performed a set of bench presses to failure at 5 reps, rested 4 minutes, and threw the medicine ball again.

The Result: After performing the bench press, the subjects increased their throwing distance by over 5%.(1)

Comments: Strength coaches like Ian King have speculated for years that the performance of explosive weight lifting movements directly before competition could improve anaerobic power. This study shows that this may be true. A word of caution, though. I would've liked to have seen whether the improvement on the second throw was really a result of the performance of the bench press, the performance of a practice throw, or the combination of the two. The second throw might be improved by simply performing a practice throw or two. So the next time you're involved in a keg-tossing contest, warm up with a practice throw followed by a 5 rep set of bench. Then chuck that keg halfway across your poor neighbor's yard. There's no doubt you'll be the stud of the party after that!

How long should I rest between sets?

The Study: On separate days, 15 men completed 3 sets of bench press to exhaustion at 85% of their 1RM with 1, 2, 5, 8, 12, and 15 minutes rest between sets.

The Results: Average repetition performance (around 6 reps per set) was greater in the 5-plus minute ranges. The authors conclude that resting from 3-6 minutes between sets may optimize time without sacrificing performance.(2)

Comments: Finally, the recommendations for rest between sets have been investigated! This study was fairly well designed and it does appear that if you're training for strength, you should be resting about five minutes between sets. These recommendations, however, are valid for strength training only and don't necessarily apply when training for hypertrophy or to get leaner. When training for hypertrophy or fat loss, I'd recommend between 1-2 minutes between sets.

Does warming up affect my power?

The Study: 12 men warmed up with either 10 concentric reps at 50% 1RM, with 6 concentric reps at 75% of 1RM, or with 4 eccentric (negative) reps at 120% of 1RM. After 2 minutes of rest, they did a set of bench press at 70% of 1RM (this is usually between 9 and 14 reps). Muscle power was analyzed.

The Results: Average power and peak power were increased with the 75% of 1RM and 120% of 1RM warm-ups vs. the 50% of 1RM warm-up.(3)

Comments: During this hypertrophy-type set scheme (9-14 reps), it appears that while warming-up, using heavier loads performed short of failure is the way to go. Once again, the strength coaches are ahead of the researchers in recommending lower reps with heavier loads during warm-ups for increasing power during work sets. For safety reasons, I prefer the set of 6 reps at 75% to the heavy negatives for warm-up. For ego reasons, I hate the idea of unloading the bar after the warm-up set to perform my work set, but this appears to be the best method.

Is there a shoe that makes you run faster and jump higher?

The Study: Seventeen men were trained for 8 weeks using resistance training and sprint/plyometric training. Group one wore regular athletic shoes. Group two wore the Meridian Sports training shoe designed to increase speed and jumping ability.

The Results: Subjects in group two improved by about 2% over group one in the 60-yard sprint and in vertical leap height. There were no differences between groups in max squat, 40-yard sprint times or jump squats.(4)

Comments: So there is a shoe that can make you run faster and jump higher. So much for all the old jokes. Although the increases weren't huge, it has been estimated that a small increase in performance on these tasks could mean the difference between winning and losing in elite athletes. A 2% increase in the vertical leap means that a 30 inch vertical leap becomes a 30.6 inch vertical leap and that a 4.5 second 40 yard sprint becomes a 4.4 second sprint. Not outstanding, but not too shabby.

Does it matter which bar I use when doing seated rows?

The Study: 33 subjects did a set of 10 reps (70% 1RM) of seated rows with a vertical grip (hands close and facing each other) or with a horizontal grip (hands wide and facing down).

The Results: Muscle electrical activity showed greater recruitment of both the upper and lower trapezius fibers with the horizontal grip (wide).(5)

Comments: Surprise, the old parallel grip row bar (V-bar) that nearly everyone uses for the seated row sucks! From now on, when I'm doing seated rows, it will be with the wide, palms down grip. Look out Ronnie Coleman!

How can I get the best hamstring development?

The Study: 11 subjects did both standing leg curls and Romanian dead lifts.

The Results: Standing leg curls showed greater activation of surface hamstring muscles while Romanian dead lifts showed superior recruitment of deeper muscle fibers. Overall the deadlifts recruited more muscle fibers.(6)

Comments: So mass movements like deadlifts actually increase muscle recruitment over leg curls? Shocking! Subjects not only recruited more fibers but also experienced more soreness. For freaky big hams, do your deadlifts!

Am I going to get killed lifting weights?

The Study: Research was conducted on weight training injuries and deaths in 1998.

The Results: Weight training accounted for an estimated 60,000 emergency room visits and at least 6 deaths in 1998. Deaths were a result of home bench press and other supine (lying) free weights. 79% of the injured were males. 38% of the visits were by 25-44 year olds and 35% were 15-24 year olds.(7)

Comments: Lifting weights might kill you! Then again, that which does not kill you only makes you stronger. I like the idea of that. Just be careful out there, okay?

DIET AND NUTRITIONAL SUPPLEMENTATION

How can I increase my IGF-1?

The Study: 18 men and women received placebo or 20 g per day of bovine colostrum for 14 days.

The Results: IGF-I was increased 17% with colostrum vs. placebo treatment.(8)

Comments: Interesting findings. I'm not certain that a 17% increase in IGF-I can really make a difference in muscle gains, but every little bit may help. Twenty grams per day is also a pretty large dose. I'm going to cop out on this one and say that more research is needed to see if bovine colostrum can really contribute to muscle gains.

Should I add glutamine and BCAAs to my protein drinks?

The Study: Subjects were weight trained for 10 weeks and ingested 2.1 g of protein/kg/day (That's about 190 grams per day for a 200 lb man). Group one took 40 grams of supplemental whey protein per day. Group two took 40 grams of whey, 5 grams of glutamine, and 3 grams of BCAA's.

The Results: Group two showed increases in bodyweight (2.6 lb), increases in strength, and decreases in post exercise lactic acid build up (a measure of exercise recovery) vs. group one. There was no difference in fat mass between the two groups.(9)

Comments: I've been a proponent of supplemental glutamine in athletes for years now. Unfortunately until now, most of the studies have been on clinical patients. This was a nice study that finally showed that in normal subjects, a high protein diet supplemented with whey protein, glutamine, and BCAA's can increase lean mass, body weight, and strength. Any of you supplement companies out there want to donate some glutamine and BCAA's to the Help Get John Berardi Huge Fund? I'm taking both cash and supplement donations.

Can vitamins decrease muscle soreness?

The Study: 8 males received 400 mg of vitamin C and 8 received placebo for 2 weeks prior to an intense exercise bout consisting of a 90 minute shuttle run test.

The Results: The vitamin C group reported less soreness 24-48 hours later and had lower levels of specific blood markers of muscle damage.(10)

Comments: Nothing really new here. Vitamin C has so many benefits for intensely trained athletes, so if you're training hard, take your Vitamin C.

Is creatine really safe?

Here are two interesting creatine studies:

The Study: 36 men and women received creatine or placebo at 10 grams per day for 56 days.

The Results: There was NO measurable impact on kidney function.(11)

Comments: This study is interesting because it was the first to measure kidney function directly in response to creatine intake through something known as glomerular filtration rate. Traditionally, kidney function was measured indirectly by blood creatinine which is elevated with kidney damage or with creatine intake. This has lead many health experts to falsely believe that creatine can damage the kidneys. This study showed that although creatinine was elevated with creatine intake, direct measures of kidney function showed no kidney damage. So here's a message to doctors out there: Don't sweat the kidney thing with creatine!

The Study: 100 NCAA Division I Football players were given creatine or non-creatine containing carb/protein drink after workouts for one full year.

The Results: No differences in any of over 50 different clinical markers of health were observed including injury or cramping. (12)

Comments: Again, despite all the media sensationalism, uniformed health care practitioners, and anti-creatine campaigns, there's repeatedly no evidence for health problems with creatine administration. A message for all the creatine naysayers: Here are your long-term safety studies! Now get off our backs!

Does ribose increase performance?

The Study: 20 men were supplemented with 8 gram doses of placebo or ribose over 3 days and performed 10 second cycle sprints in order to assess performance.

The Results: Ribose appeared to increase peak and average power in cycle sprints, especially during repeated sprints.(13)

Comments: Here's my chance to rip apart my own study. This is a preliminary study that was designed to see if there was any immediate benefit of ribose intake. Although the data are a bit mixed with respect to performance benefits with ribose, we believe that ribose may actually offer some benefit during repeated bouts of exercise like cycle sprinting or weight training. These benefits may be both acute and chronic in terms of immediate performance enhancement as well as long term training improvement. This is just speculation at this point, though. Again, more studies are needed and these should look at long term use, its specific use in weight training, and the effects of creatine-like loading with ribose. For now, give ribose a try and let me know what you think.

Can my post-workout drink or meal affect my mood?

The Study: 10 men received each of 4 different post-workout meals immediately, 2, and 4 hrs after training. Meals (except placebo) all contained the same amount of calories:

1. Whole food: 35 protein, 75 carbs, 7 fat
2. Liquid meal: 35 protein, 75 carbs, 7 fat
3. Carb drink: 0 protein, 125 carbs, 0 fat
4. Placebo: 0 calories

Moods were assessed before exercise and after the last feeding (4 hrs later).

The Results: The carb group was more fatigued, more irritable, and more mentally dull than the other groups.(14)

Comments: Very cool study! It appears that not only does a mixed post-workout meal increase protein synthesis and glycogen resynthesis, but it also improves mood and mental sharpness. No more high carb post-workout meals unless you want to be tired, pissed off, and dumb for a few hours afterward. Oh yeah, that many carbs at once tends to also create a good deal GI distress, namely gas. So, what have we learned? The very high carb post-workout drink seems to be one of the best anti-social cocktails out there.

Does andro affect strength, blood hormones, anaerobic performance or body comp?

Here are a couple of andro studies, one on oral andro and one on sublingual andro:

The Study: 200 mg of oral a-dione or a-diol were given to older men (35 to 65 years old) during a 12 week resistance training program.(15)

The Results: When taken with resistance training, neither appears to impact body composition or strength vs. placebo treatment. Estrogens and DHEA were slightly elevated after 12 weeks, Testosterone remained unchanged, and LH was slightly suppressed.

Comments: Well, another anti-andro study. How many oral andro studies do we have to see to know that the stuff simply doesn't increase test or muscle mass in low doses? Talk about overkill! At these doses orally, there's virtually no absorption. If you want to increase estrogen, suppress LH, and waste a whole bunch of money, buy up all the oral a-dione and a-diol you can. One more comment. I'm not sure that many of the andro researchers know how andro is supposed to work. If oral andro does have a major impact on hormonal levels it would be for a short period after administration, not a day or more later. Collecting hormone data this long (over 24 hrs) after the last dose (as they did in this study and others) is analogous to trying to see if taking a single dose of aspirin on Monday would prevent a headache later in the week. Get with the program, guys!

The Study: 8 men received a single dose of either 150 mg of a sublingual/buccal prohormone mixture consisting of mostly a-diol or a placebo.

The Results: Testosterone was increased by about 100% while there were no changes in estrogens, heart rate, blood pressure, grip strength, vertical leap, or a maximal 30 second cycle sprint.(16)

Comments: As opposed to the study above, the researchers in this study (Tim Ziegenfuss and myself) did measure the effects of a blend of prohormones for a few hours after a single sublingual dose. The mixture does appear to increase (actually double) testosterone levels with no impact on estrogen. In addition, in conjunction with this study, we gave subjects 450 mg of the blend per day for 4 weeks. We saw increases in lean mass, total body mass, and vertical leap with no impact on estrogens or any health parameter. It looks like sublingual andro is superior to oral andro and that a mostly a-diol blend can impact mass and performance. I'm glad that I was involved in this study because I got loads of this stuff for free and am chewing it up like candy! Look out ladies!

What is the real relationship between protein and carb intake, total calories, and body fat?

The Study: Most college athletes have caloric intakes far below their caloric expenditure thereby potentially slowing metabolic rate. This study sought to find out how their eating habits affect their body fat percentages.

The Results: In these athletes, higher calorie intakes and higher protein intakes were related to lower body fat and higher lean mass. Lower calories and protein and higher carb intakes were related to higher body fat levels.(17)

Comments: Contrary to popular belief, you need to eat to get lean. As we have known for years, consuming far too few nutrients and calories tends to lower metabolic rate and make it more difficult to lose body fat. In this study, the authors have shown that in college athletes, those who eat higher calories and protein tend to be leaner than those who eat low calories, protein, and high carbs (the high carb diets were associated with lower calorie intakes). Obviously, however, too many calories would tend to make one fatter. It appears that there is a U shaped curve with respect to calories, protein, and body fat. If you want to be as lean as possible, eat close to or just below your caloric and nutrient needs.

Do those 40-30-30 products actually have a different glycemic response than others such products?

The Study: 27 subjects consumed 7 different products on consecutive days including: 40-30-30 bar, 40-30-30 powered drink, 40-30-30 food meal, high carb bar, high carb drink, weight loss drink, and white bread.

The Results: Results showed that the high carb foods increased blood glucose more rapidly than the 40-30-30 foods and dropped below baseline more rapidly. Authors conclude that the 40-30-30 foods elicited a more sustained and level blood glucose level.(18)

Comments: Ok, so there's some evidence that the Zone meals (40-30-30) do offer the benefits of lower glycemic index (rate at which food enters the blood stream as glucose), less insulin response to meals (high insulin can make you fatter), and more sustained blood glucose. Theoretically this can help with weight loss and performance by preventing energy highs and lows, curbing appetite, and preventing large amounts of calories being driven into fat cells. These are some of the drawbacks of high carb diets. Bodybuilders have been talking about great physique benefits from diets close to the proportions of the Zone diet with 30-40% complete protein, 30-40% low glycemic carbs, and 20-30% good (unsaturated) fats.

DRUGS

Is there anything new on the GH front?

The Study: KP-102 is a GH scretagogue (stimulates GH release) that is more easily administered, costs less, and has a potentially better safety profile than GH. It was administered to rats for 7 weeks.

The Results: KP-102 administration increased body weight and muscle mass of rats. When subjected to unloading of the hind limbs (to induce muscle atrophy), KP-102 appears to prevent atrophy but isn't as effective as GH.(19)

Comments: I think drugs that can influence the natural release of hormones are the way to go. Although this particular experimental drug was not as effective as GH at preventing atrophy, it does increase muscle mass in rats and its potential benefits may make it a better choice for, um, clinical populations. I'd like to see some human data as well as some animal data in normal animals who haven't been subjected to atrophy. It would be interesting to see if KP-102 would work well alone or with a combination of Testosterone and insulin, the stack of choice for many of today's massive (and drug crazy) bodybuilders. I'm sure that once this drug gets a name (K-102 doesn't exactly roll off the tongue), I'll be hearing some immediate feedback on how well it works.

Can T levels be restored in former anabolic steroid users?

The Study: Two hypogonadal former anabolic steroid users were studied. Normal levels of LH are >3.6 IU/L and Testosterone are 300-1000 ng/dl. Former anabolic steroid users often have suppressed levels of both.

The Results: Subject #1 is a 6', 206lb former user of 500-2000+ grams per week of anabolics. His baseline numbers were: LH<1IU/L, Test=191ng/dl. This suject underwent a 32 day treatment of 2500 IU of HCG every 4 days, 50 mg of clomid 2 times per day, and 10 mg nolvadex per day. 15 days after treatment his numbers were: LH=5.2IU/L, Test=1072 ng/dl.

Subject #2 is a 5'10", 184lb male who used 400 mg per week of nandrolone. His baseline numbers were: LH<1IU/L, Test=45ng/dl. This subject's 32 day treatment consisted of 2500 IU of HCG every 4 days, 50 mg of clomid 2 times per day, and 10 mg nolvadex per day. There was no change. He underwent another treatment consisting of 60 days of 5000 IU of HCG every 4 days for 4 injections, then 2500 IU every 4 days for 4 injections, 50 mg of clomid 2 times per day, and 10 mg nolvadex per day. Still, no change. For the next 32 days, this subject received 5000 IU of HCG every other day for 6 injections, then 2500 IU every other day for 6 injections given with 150 IU of menotropins, 50 mg of clomid 2 times per day, and 10 mg nolvadex 2 times per day. 15 days after treatment his numbers were: LH=9.8IU/L, Test=507 ng/dl.(20)

Comments: The authors of this paper have presented some very interesting data that the medical community needs to learn from. When dealing with former androgen users, there may be better ways to increase Testosterone than the standard patch treatment (which will only prolong the problem of decreased T production.) Hypogonadal former androgen users need a treatment, not a band-aid. If you need to jump start your Testosterone after an androgen cycle, this combination of HCG, Clomid, and Nolvadex may be just what the doctor ordered. Now, trying to get him to order it is another story!

What's new with Clenbuterol?

The Study: Rats were injected with clenbuterol or placebo for 21 days.

The Results: The rats really didn't like the researchers after 21 days. Also, clenbuterol increased hind limb skeletal muscle mass by 15-20% when muscle weight was measured as percentage of total body weight. However, Clenbuterol increased markers of muscle oxidative damage (hydroperoxides and glutathione peroxidase ) by about 40-45%.(21)

Comments: Clenbuterol has been viewed by many bodybuilders as a wonder drug that could increase muscle mass, dramatically reduce body fat, prevent loss of lean mass after cycles of steroids, etc. Heck, I've even seen data that it could increase muscle regeneration in the atrophied muscles of paraplegics without exercise. Do these benefits come at a cost, though? It appears so. This study showed that clenbuterol seems to act as a potent pro-oxidant and can induce oxidative muscle damage. Pro-oxidants can damage not only intracellular proteins, but can also affect DNA, RNA, and cell membranes - not good. If clen is your thing, perhaps taking this pro-oxidant with anti-oxidants like vitamins A and E or alpha lipoic acid may prevent some of its negative effects.

Will the T-mag staff ever score with a fitness chick?

The Study: 200 fitness chicks were asked if they'd ever bump uglies with members of the T-mag staff.

The Results: Laughter and blank stares. One researcher was slapped and called a pig; another was given a list of services and prices.(22)

Comments: It ain't gonna happen until they can afford Lamborghinis. Okay, so I made that last one up. (Sorry, couldn't resist.) So, what all did we learn this year? Well, we learned that T-mag strength coaches like Poliquin and King are usually several years ahead of researchers. We learned that high carb diets are just as bad as we thought they were. And we learned that drugs are like human nature: both good and bad at times. Hope you found it educational.

References:

1.The Acute Effects of a 5RM Bench Press on Power Output, A.K. Evans et. al

2.The Effect of Rest Interval Length on Multiple Set High Intensity Bench Press Performance, J.B. Todd et. al.

3.Force Exerted During a Warm-Up Set Affects the Muscle Performance in Subsequent Resistance Exercise, D. Hamar et. al.

4.The Effects of Training with the Meridian Athletic Shoe on Sprint and Vertical Jump Performance, N.A. Ratamess et. al.

5.An Electromyographic Study of the Trapezius Muscle During the Seated Row Exercise, G.J. Noffal et. al.

6.Electromyographic Analysis Comparing Romanina Deadlift vs. Leg Curl in Activating Muscle Fibers of the Long Head of the Biceps Femoris, M.A. Swain et. al.

7.1998 U.S. Weight Training Injuries and Deaths" V.P. Lombardi et. al.

8.Bovine Colostrum Supplementation Increases Serum IGF-I, IgG, and Saliva IgA in Athletes During Training, A. Mero et. al.

9.Supplemental Protein Influencing Body Composition and Strength in Athletic Adults, C.M. Colker et. al.

10.Muscle Soreness and Damage Following Two Weeks Vitamin C Supplementation, D. Thompson et. al.

11.Effects of Oral Creatine Monohydrate Supplementation on Renal Function in Adults,K. Kuehl et. al.

12.Long-Term Creatine Supplementation Does Not Adversely Affect Clinical Markers of Heath, R. Kreider et. al.

13.Effects of Ribose Supplementation on Repeated Sprint Performance in Men, J.M. Berardi et. al.

14.Alterations in Mood Following Acute Post Exercise Feeding with Variance in Macronutient Mix, R.J. Bloomer

15.The Andro Project: Androstenediol or Androstenedione Use on Body Comp in Men, The Andro Project: Androstenediol or Androstenedione Use on Strength in Men, The Andro Project: Androstenediol or Androstenedione Use on Sex Hormones in Men, J. Quindry et. al.

16.Effects of an Androgen Mixture on Testosterone, Estradiol, and Anaerobic Performance in Men, T.N. Ziegenfuss et. al.

17.Relationship of Energy Intake to Body Fat Percentage and Bone Mineral Density in Collegiate Tennis Players, H. Olivia Thomas et. al.

18.Glycemic Response: Comparison of Different Nutritional Bars and Drinks, S.M. Ceriale

19.Chronic KP-102 Treatment Increases Body and Muscle Mass in Normal and Hindlimb-Suspended Rat., Y. Hanai et. al.

20.Pharmaceutical Intervention of Anabolic Steroid Induced Hypoonadism: Our Success at Restoration of the HPG Axis, M.C. Scaly and C. Street

21.Clenbuterol Increases Lipid Peroxidation in Hindlimb Skeletal Muscle, A.Dirks et. al

.22.Why are you looking for a reference? I made it up, remember.