In an appearance on the 2 Bears 1 Cave podcast, Stanford neuroscientist Dr. Andrew Huberman discussed some telltale signs that may indicate PED use. While emphasizing that there can be exceptions, Huberman outlined a few key physical traits to look out for:
Facial creasing: Huberman noted that PED users, particularly those on testosterone replacement therapy (TRT), often develop deeper creases between their nose and cheeks. He explained this is due to fluid retention from increased estrogen levels associated with testosterone use.
“You’ll notice that when people go on TRT (testosterone replacement therapy), the creases in their skin can become deeper due to some edema and tissue retention that comes from increased estrogen levels. ”
“If you look at the creases between the nose and the cheeks, you can see how deep they are—almost as if the cheeks are trying to crawl up to the nose. So, even though someone might be lean, they can still have edema, which is fluid retention. This occurs because some of the testosterone converts to estrogen. As a result, people often start taking estrogen blockers, known as aromatase inhibitors. ”
“A lot of people don’t realize that if estrogen levels are pushed too low, whether in males or females, libido can crash. Many bodybuilders who appear to be wrapped in Saran Wrap often report that their libido is not great. You don’t want to crush your estrogen levels; it’s important to find a balance—not too high and not too low.”
Prominent veins: A bulging vein on the left side of the neck, visible even when the person is not exercising, can be an indicator of elevated blood pressure from PED use.
“However, there’s more to consider, like the left-side vein that bulges when someone talks, indicating elevated blood pressure, which is common among those on high levels of TRT or steroids. This can also be seen in normal people during physical activity, but it’s often more pronounced in conversation among those using performance enhancers.”
Skin changes: PED users may develop a ruddy or reddish skin tone due to increased blood flow.
“There are also noticeable physical signs, like the reddening of the skin due to increased blood flow. Many individuals take vasodilators like Cialis and Viagra to enhance their muscle pump before photo shoots or competitions. It’s a whole world. Interestingly, low-dose Cialis was originally prescribed as a prostate drug because increased blood flow to the prostate can help mitigate issues like prostate cancer and frequent nighttime trips to the bathroom. Many NFL players take Viagra before games to lower blood pressure and improve blood flow.”
Muscular development: Disproportionately large deltoids (shoulder muscles) and trapezius muscles can be a sign of PED use, as these areas have a high concentration of androgen receptors.
“Additionally, a telltale sign of steroid use is the shoulder muscle development. There are a lot of androgen receptors in the deltoids and trapezius muscles. Some people say the real telltale is the creasing in that area. Even those on TRT often exhibit this, but there’s a fine line between TRT and full-blown steroid use. In some professional sports, I’ve heard directly from players that if you have an injury, you can take up to 200 milligrams of testosterone per week. This is usually what’s distributed over a two-week period for a standard TRT. I won’t specify which league, but in basketball, players often discuss it openly.”
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Lean and vascular physique: While acknowledging genetic exceptions exist, Huberman suggested that an extremely lean and vascular physique, especially in older individuals, often indicates PED use.
“When people have a huge physique and they’re hypervascular sure there’s some possibility of a genetic freak there but um actually I know one”
Huberman emphasized that these signs alone are not definitive proof of PED use, as there can be natural genetic variations. He also discussed how some Hollywood actors and professional athletes use PEDs, including testosterone, growth hormone, and peptides, to maintain muscular physiques or enhance performance.
The neuroscientist advocated for more transparency around PED use in entertainment and sports, suggesting it could help set realistic expectations for the public about achievable physiques and performance levels.
Huberman clarified that he has experimented with low-dose TRT in the past for research purposes.
He stressed the importance of natural, science-based approaches to fitness and health, which he regularly discusses on his popular podcast.