Lead Astray? The Hidden Contaminants in Australian Anabolic-Androgenic Steroid Market and Their Potential Health Impact.

Introduction: Unregulated anabolic-androgenic steroid (AAS) markets are a global phenomenon with significant variability in product composition and purity. This study aimed to determine the chemical composition of AAS sold in Australia.

Methods: This study analysed anonymously donated AAS samples. Samples were chemically analysed by an independent forensic laboratory using gas chromatography-mass spectrometry, liquid chromatography-mass spectrometry and inductively coupled plasma analysis to identify active ingredients, contaminants and heavy metals, with results interpreted in the context of harm reduction.

Results: Analysis of 28 AAS samples (16 injectable, 10 oral, 2 raw powders) revealed that 15 samples were mislabelled or mis-sold. When considering the 21 samples with clearly defined expected labelled dosages, 4 of these were within a ±5% deviation of the expected purity. Twelve heavy metals were detected in injectable and oral products, with mean concentrations ranging from 0.07 to 62.54 μg/mL in injectables and 1.94-47,901 μg/g in orals. Seven metals were identified in raw powders (mean 23.0 μg/g, range 0.96-51.73 μg/g).

Discussion And Conclusions: The variability and contamination of AAS products pose significant health risks. Implementing a comprehensive surveillance and testing system is essential. This approach would track trends, identify contaminants and provide consumers with real-time, accurate information to support informed decision-making and harm reduction.