When you talk to high-level lifters in untested federations, you hear two things again and again: performance comes first, and nothing is free.
“More drugs means more stress on my body”: what elite strength athletes say about PIEDs
A new qualitative study sat down with 17 elite strength athletes (powerlifting, bodybuilding, strongman/woman) to ask how they actually take performance and image-enhancing drugs (PIEDs), what helps, and what hurts.
The headline
PIEDs are a double-edged tool. Athletes take them to recover faster so they can train harder but that added capacity also ramps up total stress on the body. In other words: yes, drugs can help you do more work; they also make the workload – and the health bill – bigger.
“These drugs help us recover… so we can put more stress on the body to adapt. More drugs, more stress.” – National-level lifter
What athletes actually do
- Timing around comps. Higher doses cluster in prep phases, then pull back post-meet.
- Track health like a hawk. Blood pressure, resting heart rate, weight swings, sleep, labs athletes build simple dashboards to spot trouble early.
- Rely on lived experience. Most don’t go it alone; they lean on coaches and trusted peers who’ve cycled before and can reality-check choices.
- Respect side effects. Lifters called out blood pressure spikes, liver/kidney load, anxiety, and mood shifts especially when pushing dose or stacking compounds.
The mind game: not just muscles
Several athletes described anxiety, irritability, and “identity dips” both on cycle (dose-related jitters) and especially coming off after long runs. The smart move they described: plan for the psychological off-ramp (taper, support, structure), not just the physical one.
The “non-human helpers”
Wearables, blood pressure cuffs, bathroom scales, training logs these biometric guardrails matter. One lifter explained how reviewing cycle timing plus sleep and HR data turned a bad session from “I’m broken” into “I know why that happened.” Data lowers panic and improves decisions.
What this means if you’re in the arena
We’re not glamorising use. We’re sharing what the best-in-class do to reduce harm when they’ve already decided.
If you’re an athlete:
- Periodise everything – training, food, sleep, and compounds. Peaks need planned deloads.
- Create a simple health stack: BP monitor, resting HR, bodyweight trend, sleep log, regular labs.
- Use dose ceilings and exit rules: write them down before prep starts. Emotion is a terrible coach at Week -3.
- Have a coach/peer with lived experience who can say “no” when you won’t.
- Plan the off-cycle as hard as the peak: mood, sleep, libido, training volume, social support.
If you’re a coach/club:
- Normalise health checks (BP cuffs on the gym shelf).
- Build a referral lane to non-judgemental medical support and confidential testing (that’s where PEDTest and RoidSafe come in).
- Teach athletes the difference between “I can” and “I can recover from”.
The bigger picture
Untested elite scenes often run on polypharmacy and high workloads – that’s the culture. The athletes in this study weren’t naive to risk; they were active managers of it. The gap isn’t willpower, it’s good information, early monitoring, and honest coaching.
