Looking at the reemergence of stanozolol in Major League Baseball news

Since March 27th, three Major League Baseball players have tested positive for stanozolol: David Rollins of the Seattle Mariners, Arodys Vizcaino of the Atlanta Braves, and Ervin Santana of the Minnesota Twins, clearly the highest profile player of the three. If stanozolol sounds familiar to you, it is likely because of Rafael Palmeiro, as it was widely reported that stanozolol (often referred to as its easier-to-pronounce brand name Winstrol) was the performance-enhancing drug (PED) he tested positive for back in 2005. What exactly is stanozolol? Let's take a look:

Whenever you see that four-ring drug structure (outlined in yellow and commonly called the drug "skeleton"), the very first thing that should come to mind is "steroid." Now, steroid in itself is an inherently broad term. Our body makes variations of it every single day (i.e. testosterone), some people use steroids for seasonal allergies (i.e. Flonase), and others use steroids for itching or rashes on the skin (i.e. hydrocortisone), among many other uses. In this case, stanozolol is a 17 alpha-alkylated synthetic anabolic steroid, derived and modified from testosterone for increased anabolic (muscle-building) effect.

Each position on the structure is denoted by a number, but to keep things as clear as possible, I only pointed out the 17 position, as this is where an extra methyl group (carbon + three hydrogens) was added when producing stanozolol. The reasoning behind the addition of a methyl group is that it allows for oral use, which is understandably preferred over painful injections into the muscle. In short, if the methyl group wasn't there, the liver would deactivate it soon after being taken.

Naturally, steroids have androgenic (male sexual characteristics) and anabolic (muscle-building) effects. What athletes are looking for (and what manufacturers were trying to do when creating these synthetic steroid products) is the anabolic effect. Unfortunately, manufacturers were unable to remove androgenic effects completely, so those taking these products must deal with both effects. Thus, how do they work? Per the British Journal of Pharmacology, anabolic steroids utilize various mechanisms of action to produce the desired result—muscle building—with the most common being increased protein production in skeletal muscle cells.

Of note, there are also two theories involving possible positive effects seen from anabolic steroids. One states that they not only have an anabolic effect but an anticatabolic effect as well, which essentially means they help prevent the breakdown of muscle (for clarity, anabolism: build-up/synthesis, catabolism: breakdown). For those interested, this is the mechanism associated with faster recovery times, an effect commonly associated anabolic steroids. Another theory (by RV Brooks in 1978) looks at the aggression associated with anabolic steroids and reasons that athletes can "recognize and harness the increase in aggression that can arise with steroid use to help drive their training and increase their competitiveness." To my knowledge, neither of these theories have necessarily been proven, but they are reasonable enough to the point where some people simply believe them to be true.

Now that we know a little bit about the mechanism of action for stanozolol and other anabolic steroids, it is time to get back to the main point of the article: stanozolol is in MLB news again, why? To be fair to Santana, Rollins, and Vizcaino, I am not going to theorize as to why each individual took stanozolol. There is no denying the fact that muscle building does indeed occur in those who take anabolic steroids. However, I have not yet found a study that specifically shows they enhance the performance of baseball players (please share one if you have) and as with almost any drug, there is a pretty lengthy list of not-insignificant adverse effects.

One final thing to note regarding stanozolol and positive tests is that even though it is commonly taken in an oral form (often seen as advantageous for having a much shorter half-life than intramuscular injections), it can still be detected in the body for a week or even up to a month, depending on the person taking the substance. Thus, players can seemingly take it during the offseason and clear it from their system by the time the next season starts, but with an increased focus on offseason testing, significant risks must be taken by the player given that the drug can show up in a test up to one month after taking it.

Of course, there is always the possibility that the player in question unknowingly took the banned substance. Players who have tested positive for banned substances have been saying this for quite some time. The following is from an official statement by Santana released by the Twins:

"I am frustrated that I can't pinpoint how the substance in question entered my body. I would never knowingly take anything illegal to enhance my performance. What I can guarantee is I never knowingly took anything illegal to enhance my performance. That's just not me, never has been and never will."

Unfortunately for Santana's reputation, all we can go by is the positive test and the 80-game suspension he received as a result (which he accepted without appeal). If he did indeed take stanozolol unknowingly, he knows to "be more vigilant of medications [he] takes so that [he] doesn't commit another mistake." While testing has advanced immensely and players like Matt Carpenter are signing pledges against PEDs, they are not going anywhere. Whether or not baseball players benefit from a performance standpoint is still unclear but there is, at minimum, a perceived benefit, and sometimes, that is all a player needs. As a result of PEDs not going anywhere, players are going to test positive in the future. I would gain a ton of respect for the first player to own up to their mistake right away, largely because I've grown weary of the "I didn't knowingly take anything illegal" statement, whether it is true or not.

As to why stanozolol has made news lately after nearly ten years of silence, your answer is as good as mine.

April 11, 2015 UPDATE: It has been reported that New York Mets reliever Jenrry Mejia has also tested positive for stanozolol and has accepted an 80-game suspension from the league.