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Kimbo Slice: How Steroids Harm the Heart

kimbo sliceKimbo Slice was a Bahamian-born American Mixed Martial Arts (MMA) fighter, street fighter and boxing star who has more than 100 videos on YouTube with millions of views.  On June 6, 2016. he was admitted to Northwest Medical Center in Coral Springs, Florida in heart failure.  He had a mass in his liver and was so short of breath that he had to be placed on a respirator. Arrangements were made to send him to Cleveland for a heart transplant, but it was too late.  He died of heart failure at the very young age of 42.
Just four months before his death, he fought his last professional fight, knocking out Dhaffir “Dada 5000” Harris in the third round.    Before the fight, doctors examined him and he passed both an EKG heart test and an EEG brain test.  After the match, his opponent had to be hospitalized for kidney failure, and the Texas Department of Licensing and Regulations announced that Kimbo tested positive for the steroid norandrolone.  At that same time, another fighter, Ken Shamrock, also tested positive for the same steroid, and for methadone, a narcotic pain killer.  Adding a narcotic to the steroid increases the risk for permanent heart damage.  
Incredibly, the standard punishment by MMA for failing a drug test in Texas is a 90-day suspension and $5000 fine.  That is a meaningless penalty for taking a drug that can kill you.  The fighters are seldom caught because MMA tests for drugs only on the day of a fight.  The urine test remains positive only for a few days after taking norandrolone pills (Br J Sports Med. July, 2006;40(Suppl 1):i25–I), so fighters just have to stop taking the drug a week before the fight and they can pass the urine test. 


From Extreme Poverty to Extreme Wealth
He was born Kevin Ferguson in Nassau, Bahamas and came to the United States before he started school.  His family was very poor. As the oldest son of 11 children, he was raised mostly by his mother.  At Miami Palmetto High School, he was a star middle linebacker on the football team.   In 1992, Hurricane Andrew caused his senior-year football season to be cancelled, so no college scouts saw him to offer a football scholarship.   His home and entire neighborhood were destroyed by the storm,  so he lived in his 1987 Nissan Pathfinder with plastic bags taped to the broken windows to keep the rain out.  He went to Bethune-Cookman University and University of Miami, but dropped out because he had three children to support.  The only jobs he could get were washing cars, driving a limo, and being a bodyguard and strip club bouncer. In 1997, at age 23, he tried out for a spot on the Miami Dolphins football team, but failed.
In 2003, at age 29, he became a street fighter, competing in people's backyards.  In his first videotaped street fight with a person who terrorized his neighborhood, he dropped his arms and let his opponent punch at his face, and then knocked him out.  Videos of his violent knockout win were put on YouTube, which helped him gain fame around the world.  He earned $3000 for that fight and the video got more than a million views on YouTube.  His YouTube fans started to call him "Slice" because his punches opened up a huge cut under his opponent's eye. He matched that with his childhood nickname "Kimbo" to become "Kimbo Slice". 


In more than 20 fights, he lost only once.  His YouTube fights made him famous and in June 2007 he moved up to fighting in MMA and won his first four fights.   At 6'2" and 240 pounds, with huge muscles, a shaven head, a long, black beard and a golden tooth, he looked like the most menacing fighter imaginable and was featured in Rolling Stone, Time and ESPN.  He went from having to sleep in a car to being chauffeured in stretch Navigator limousines and flying in private jet planes.  He now owned a five-bedroom home with a pool in a gated community in western South Florida, was the proud father of six children, was engaged to his long-time girlfriend, Antoinette, attended his children's high school games, paid his kids' college tuition, and was a respected and adored member of his community.  After watching him fight, you will see the tremendous courage, pain and abuse it took to be an MMA fighter, yet even his opponents said he was a really nice, gentle guy out of the ring.  One of his sons, Kevin "Baby Slice" Ferguson, now fights in the MMA.  It is heartbreaking when the beloved head of a large family dies at such a young age. 
Why Male Athletes Take Anabolic Steroids 
I have never seen Kimbo Slice's medical records, so everything I write from here on is a general discussion of anabolic steroids that I hope will discourage both athletes and non-athletes from ever taking them.  
Synthetic male hormones (anabolic steroids) help athletes grow larger muscles, become stronger, have greater endurance and recover faster from intense workouts.  Many men who are not athletes take them just to make themselves more attractive. 
Strength:  Soon after starting to take synthetic male hormones, athletes observe spectacular improvements in their athletic performances. Athletes train by taking a hard workout that damages muscles, feeling sore on the next day, then going easier until the soreness diminishes, and then going hard again. As soon as an athlete starts to take anabolic steroids, he notices that he recovers much faster than before, so he can do intense training almost every day, so he becomes much stronger and a better athlete.  
Endurance: Steroids increase red blood cell counts.  The limiting factor for how fast a person can go over distance is the time it takes to get oxygen into exercising muscles. Since 98 percent of the oxygen in your muscles is carried by your red blood cells and very little is diffused in the blood fluid, anything that increases the number of red blood cells allows the blood to carry more oxygen and gives the athlete greater endurance. 
How Anabolic Steroids Damage the Heart
Athletes who take anabolic steroids are at increased risk for heart damage.  Anabolic steroids are synthetic male hormones, and taking male hormones stimulates sympathetic nerves leading to the heart to delay heart muscle recovery from exercise. Your heart rate is supposed to slow down as soon as you stop exercising. Those who take male hormones take longer for their heart rates to slow down after exercise and also have reduced flow of blood to their heart muscles (Int J Sports Med, Oct,  2013;34(10):931-5). 
Taking male hormones also causes the left ventricle, the main pumping chamber of the heart, to enlarge disproportionately, compared to the rest of the heart.  However, the anabolic steroids do not enlarge the heart nerves, so the person has enlarged heart muscles that have outgrown their nerve supply. This increases chances for irregular heartbeats and sudden death (Heart, May 2004;90(5):473–475).
Adding HGH (human growth hormone) to steroids increases heart enlargement even more, without enlarging the nerves that control the heart's contractions, to increase risk of heart failure and death from irregular heartbeats.   Synthetic male hormones also lower blood levels of the good HDL cholesterol and increase levels of the bad LDL cholesterol. They cause the bone marrow to increase production of red blood cells and platelets, which, at high concentrations, can cause the red blood cells to clump together to form clots that cause heart attacks and strokes. 
All anabolic steroids act similarly to testosterone, the male hormone. Researchers reviewed the medical records of 55,593 men who were given testosterone for low testosterone levels or sexual dysfunction and compared them to men who received Viagra or Cialis but no testosterone.  After three months, the risk for heart attacks was double in the testosterone group for all of the men older than 65, and in the men younger than 65 who had a history of heart disease (Public Library of Science, January 29, 2014).  This study prompted the U.S. Food and Drug Administration to start an investigation of the risk for heart attacks after taking testosterone.  Another study of 8709 men with low testosterone levels showed an increased risk of strokes, heart attacks, and deaths after starting testosterone (JAMA, November 6, 2013). A study to see if testosterone gel helped frail older men to build muscle and strength had to be stopped early because of a marked increase in heart attacks and one death (NEJM November 4, 2010).
Lessons From This Sad Story
Know that anabolic steroids and human growth hormone, either taken together or alone, can enlarge your heart muscle without also enlarging the heart nerves that control your heartbeat. That means that people who take anabolic steroids are at increased risk for sudden death from irregular heartbeats while they take them and this increased risk for sudden death can continue for 30 or more years after they stop taking them.  


February 8, 1974 – June 6, 2016
June 18th, 2016
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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