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Of course when everyone thinks of bodybuilding drugs anabolic steroids (AS) are the first things to come to mind, but how do they work with insulin? VERY WELL! AS decrease insulin induced fat accumulation through a number of ways. One is through creatine synthetase, which is an enzyme that goes crazy after workouts trying to store carbohydrates in the muscles (as glycogen, creatine phosphate etc.). For every gram of carbohydrate stored in muscle, roughly four grams of water go along with it (this is how creatine monohydrate achieves such dramatic results). How does this relate to insulin and AS? Well, the "harder" AS (exemplified by oxymethelone) increase creatine synthetase levels dramatically, giving insulin a place to do its' job and store carbohydrates.

Okay, this also counts for a combined anabolic effect, but it prevents insulin from converting any "excess" carbohydrate in to fat (which would subsequently be stored)! AS also decrease levels of the main fat storage enzyme that insulin increases (called lipoprotein lipase). A big effect is through glucocorticoid antagonism, which means that AS indirectly increase insulin sensitivity (as well as act anti-catabolically). This allows insulin to bind to its' receptors more easily and accomplish its' job rather, than converting more macronutrients in to fat. Finally, the demand for nutrients by muscles is so high, in an AS enhanced state, that there is rarely any excess of nutrients to actually be stored as fat! A mere 400 mgs of enanthate didn't allow me to accumulate fat whether I was using insulin or not.

From a muscular anabolic perspective, there is a synergistic effect between AS and insulin. This is because they both directly stimulate protein synthesis as well as other mechanisms. One such mechanism involves AS hepatic mediated somatomedin release. Simply put: IGF-1 production in the liver. Again, the more powerful the AS, the more IGF-1 release, with orals having a much greater effect than injectables. Insulin increases the duration of time that IGF-1 is active in the bloodstream, and enhances receptor mediated IGF-1 activity (all through enhancing specific IGF-1 binding proteins). Another great combined effect is that insulin reduces the amount of Sex Hormone Binding Proteins (SHBP) in the blood stream. This allows more AS to be active and do their job of making you grow! Great effects were seen while using 10 units of insulin only three times a week, with AS. For the first few weeks of my next cycle I'm not going off the stuff, and I expect the effects to be scary!

In case you've been living on Mars for the past few years, CAE stands for Caffeine, Aspirin, and Ephedrine. This stack has been shown to synergistically strip off fat, while preserving muscle mass. It is considered here because it is the minimum requirement, while using insulin, to prevent you from looking like the StayPuft marshmallow man. Also of benefit is that it is cheap and easily accessible. Using three times a day helps slow the fat accumulation, but strict dietary control is also necessary. The ephedrine: suppresses appetite, stimulates thermogenesis, and promotes and fat release from cells (beta receptor, and catecholamine, mediated), while the other two components of the stack increase thermogenesis by inhibiting certain enzymes and transmitters that try to slow down the thermic effect. Ultimately the appetite suppression effectiveness of ephedrine wears off, but this is replaced by a greater thermogenic effect (5-deiodinase, or Beta-3, mediated). The CAE stack does nothing for muscle anabolism in a hyper caloric situation, but that's what the insulin is for.
This "soon to be classic" post-cycle stack not only increases muscle mass, but keeps fat off at the same time. Fat loss from clen is legendary for the first two weeks. After that time, the beta-2 receptors that it activates, attenuate (because of the extremely high binding specificity), dropping the fat burning effects to minimal levels. There should still be beta-1 receptor activation (which stimulates fat release from adipocytes) and beta-3 stimulation (the big thermogenic wonders), because they attenuate slower or not at all (respectively) compared to beta-2 receptors. Clen is a much better fat burner than ephedrine, due not only to its' higher receptor specificity, but also due to it's extremely long half life (the exact reason it's not approved for use in humans). This means that the drug is constantly burning fat, especially at night when serum glucose, and insulin, are low. Using aspirin and caffeine might slow the receptor attenuation, or at least increase the thermogenesis while its there (I can certainly attest to this!). Why hasn't anyone done this sooner? Clen, like AS, directly combats the fat storing enzyme that insulin promotes (lipoprotein lipase again) in white fat. However it actually increases this enzymatic activity in brown fat (hence the thermogenesis) and muscle. The latter event could promote muscle anabolism through a similar mechanism to HMB, or at least increases muscular fat storage (merely increasing muscle size). This may not seem significant, but the way that people are going nuts over synthol, you never know! The mechanism of action of clens' muscle building effect is not known, but it appears to be anti-catabolic rather than directly anabolic. It should be noted that this anticatabolism is not beta receptor mediated , and therefore does not attenuate. At any rate, the combined effect of the two drugs can be noticeable muscle gain while keeping fat off for the first two weeks. Can fat accumulation be slowed with this stack continue past this time? I'll let you know!


There has been increasing popularity, and curiosity, concerning exogenous use of "the most anabolic hormone in the body". This makes it necessary to inform people how to maximize muscle mass acquisition and minimize nasty body fat accumulation when using it. The following is the second article dealing with the effects of exogenous insulin use, combined with several other bodybuilding drugs and supplements, from a muscle anabolism and fat catabolism point of view. Part I outlined insulin use combined with: anabolic steroids, the C/A/E stack, and clenbuterol.
Insulin has one of the highest potentials for danger of all bodybuilding drugs. It shouldn't be screwed around with.

Growth hormone (GH) is one of the most sought after bodybuilding drugs due to its' legendary abilities to strip off body fat and increase muscle mass. The former is accomplished through direct lipolysis (fat release from adipocytes), which GH does to an incredible degree. Muscle mass acquisition is accomplished through: the direct stimulation of protein synthesis, increasing amino acid uptake by muscle cells, and by greatly stimulating IGF-1 synthesis in the liver. It is this last point that is of interest to us because it is the main anabolic mechanism for GH, and it is also where insulin comes in to play. More than half of GHs' anabolic effect is due to IGF-1 production, but unfortunately this is quite often wasted. This is because IGF-1 has an extremely short half life in the bloodstream, so it usually doesn't reach many target tissues (muscles for our interest) to exert maximum anabolic effect. To rectify this situation, insulin can be used to increase the amount of an IGF-1 binding protein (specifically IGF1-BP3) that actually helps IGF-1 to reach the muscles and exert its' extreme anabolism. Insulin also reduces the amount of "bad" IGF1 BP's, (BP's 2 and 4) that would normally interfere with IGF-1 uptake and use by muscle. To say that there is a synergistic effect between insulin and GH doesn't do the combination justice. It makes me shudder to think of the hundreds of thousands of dollars spent on GH, without using it to the maximum anabolic potential. From a fat loss perspective, GH is incredible. It should directly negate the lipogenic effect of insulin, leaving you with one KICK ASS combination.

With the huge increases in fat mass often accompanying insulin use, it seems like a simple solution to use thyroid hormone. Unfortunately, this doesn't work out very well. The reason is that thyroid hormone (specifically T3 and possibly T4) increases the amount of the "bad" IGF1-BP's mentioned earlier;IGFBP2 and IGFBP4. This may not seem like a big deal if one is not using drugs to stimulate IGF-1 synthesis, but IGF-1 levels are naturally stimulated through acts like stretching, and even natural testosterone/GH increases. All of these things normally accompany workouts (if you know what you're doing), which is the best time to take insulin. So by having all of the free IGF-1 bound by IGFBP3s' evil siblings, much of the anabolic effect of insulin is lost! Since T3 (triiodothyronine) is the main culprit, does that mean that T4 (tetraiodothyronine) can be used with no detrimental effect? NO, because T4 is mostly effective by converting to T3, which leaves you with the same problem. In fact, T4 could very well do the same thing. So if you want to maximize the anabolic effectiveness of insulin while minimizing bodyfat accumulation, use another fat burner and leave the thyroid alone.

These compounds may have an anti-synergistic effect on each other, meaning that the combined effect is less than the sum of the individual effects. This possibility exists due to both components' ability to store water in muscle cells. If only a certain amount of water can be stored in the cells through each mechanism of action, then the anti-synergistic condition would exist. Although this condition is unlikely, it is worth mentioning for future experimentation purposes (lab rats know where to contact me). One definite advantage of this combination is that creatine is best absorbed by the muscles when insulin serum levels are high, insuring maximum effectiveness. BTW-if one is not doing something as fundamental as using creatine, there is no way they should be using insulin (so basically insulin use requires creatine use).

Getting straight to the point, unless you are a moron and are eating fat during insulin use, or you have crappy insulin sensitivity, HCA is the second most effective fat gain inhibitor next to clenbuterol (which is only more effective due to its' ridiculously long half life). Hydroxy Citric Acid (HCA) is the main ingredient in Citrimax, and is a bargain in terms of its': relative effectiveness (when using insulin), cost (cheap, cheap, cheap), and availability. It works by inhibiting an enzyme called ATP citrate ly(s)ase (ACL), which basically converts ingested carbs to fat (which insulin promptly stores). This is normally NOT a big deal since ACL levels are normally low in most humans. However, insulin drastically increases ACL levels (which should make sense based on what you now know about insulin) accounting for most of the, responsible use, fat gain associated with insulin use. This is the most exciting find since the discovery of insulin as an anabolic! Using insulin and not gaining fat while gaining muscle? What a concept! Although I don't like to go into the details of use directly, I believe it is warranted here. 500-750mgs HCA should be taken with or within half an hour after the insulin shot. The usually recommended 250mgs is ineffective in dealing with the drastic increase in ACL levels. The HCA is taken with the shot because both start to work on about one half hour, so the HCA can begin to be effective at the same time that insulin is trying to increase ACL levels. This regimen (only 3X500mgs HCA) prevented fat gain during a day when I used 3 separate insulin shots! To make things even better there is a mild glycogen storage property associated with HCA use. Since ingested carbs cannot be converted to, or stored as, fat, they are generally stored (due to insulin) as glycogen in muscle giving the user a mild but noticeable pump (similar to the first day of creatine use). To end this portion of the list, I give HCA my highest recommendation as the number 1 supplement to use with insulin!

Short and sweet. Don't use flax seed oil with insulin, because it is fat and *will* be stored. The fat storage rules totally change when insulin is involved (I even avoid vitamin E capsules because mine are oil based).

This may look like an ideal combination at first, but research has shown why my muscle gains with this combo were minimal. Clen reduces insulin sensitivity, which means that insulin will have a much harder time doing its' anabolic job on muscle tissue. In addition to storing amino acids as muscle, insulin also stores carbs in muscle (which gives a very "full" look to the muscles), which reduced insulin sensitivity also hinders. This is also combined with the fact that clen reduces Glut-4 transporters (which allow glucose passage, and subsequent storage, into muscle) in skeletal muscle which probably accounts for clens' ability to reduce muscle glycogen concentration. On a lighter note, the fat burning effects of clen are potentiated by aspirin and caffeine (through personal experience) but still die off after a few weeks. Overall the only time I would recommend this combination occurs when coming off a cycle and every bit of anabolism is needed, otherwise the two drugs have a bad effect (from an anabolic standpoint) on each other.

- use testosterone enhancing compounds to increase hepatic IGF-1 production
- only use insulin first thing in the morning or during/after workouts
- don't consume *any* fat 2 hours before (due to digestion time) or one hour after (due to induced enzyme activity) insulin use
- stretch to locally increase IGF-1 levels
- continually eat protein spread over the 4-5 hour duration of insulin activity
Finally, my favourite tip from Docroid: (I) use one shot of insulin just before a one hour workout and another shot two hours after the first. This creates synergism between the activity of the two shots by the later shot increasing in activity at the same time as the first shot decreases in activity, giving one a steady high insulin level at the most important time for anabolism! The only time I can say that I have seen dramatic results from insulin use (in terms of muscle anabolism) occurs when I do this "technique". HOWEVER, this is *very* tricky, in terms of serum glucose levels, even for seasoned insulin users. After using for a while, one can get used to the "feel" of insulin, blood sugar crashes, feeding times etc. but things change when one has a high level of insulin for 3-4 hours straight. I've had to eat every hour for three hours during one of my first attempts at this technique, but every two hours some other attempts. This is the only time I don't feel secure with my own insulin use. It's actually a good thing I can now recognize what a blood sugar crash feels like or I'd probably be dead due to this technique. I don't recommend this technique to anyone (and if that's not a big deal to you, just remember who is writing this) but if you feel like using it, make sure that you have had a couple of, (horrible) insulin induced, serum glucose crashes so you can recognize the early warning signs for when you have them (and you *will* have them).



*WARNING*: Insulin is not a drug to be taken lightly. It's use can harm or even kill an ignorant user. If you plan on using, educate yourself and at least read the last part of this article.


This combo has potential due to the interesting ability of insulin to increase levels of 17B hydroxysteroid dehydrogenase(17B), which is the enzyme that converts andro. into testosterone. If the increase is anything near the 17B levels that women have, this could become the stack for "natural" ???bodybuilders. Another possible benefit of this stack is the idea that insulin probably exhibits mild anti-aromatase properties. If this occurs to any significant level it could be great in increasing the 17B levels even more! Although I hate to rain on this theory parade, I have to say that I can't notice ANY anti-aromatase activity from insulin(see first update section). Other possible benefits of this stack are shown in the first part of this series under:

Of course any potential similarities with AS would be drastically minimized with andro. It should be noted that the term "natural" is used quite loosely.

Captopril is an angiotensin converting enzyme(ACE)inhibitor. Its' medical function is to reduce blood pressure. The reason it is included here is because it can have great effects with insulin and AS. I wouldn't reccomend captopril to anyone unless you are hypertensive or are using AS, because it can drop blood pressure to a sub-normal level. A reason captopril is so great is because it increases endogenous growth hormone levels, which you know can be amazing, assuming you've read last month's article. Another benefit to captopril is its' decrease in protein urea(protein loss in urine). No other drug I'm aware of, including AS, GH, or insulin, does this. This means that there will be more protein for those other anabolic drugs to assimilate! Another great use of captopril is the fat loss effect it has. For me it removes the necessity of HCA while using insulin (with AS). Although I still use one 250mgs of HCA/day just for good measure, I could probably get away witho!ut it despite the extreme carb intake after a workout. On a more esoteric note, long term captopril use actually prevents the formation of new Alpha2 adregenic receptors, which would further potentiate fat loss. Also, water retention is minimized through captopril use, which ties into the blood pressure effects. A potential risk while using captopril with insulin is that both drugs do a good job of making one tired/sleepy. Add in a late night, high intensity workout and you'rer ready for bedtime. One can NOT fall asleep while using insulin or you would experience all of the dangerous side effects associated with its' use. A final warning about captopril is that it increases the retention of potassium which makes hyperkalemia (too much potassium)a possibility. Unexcessive intake of this electrolyte should allow for avoidance of any problems in most people. This stack really doesn't have any problems associated with it, as long as common sense is used. It is merely a matter !of responsibility to point out every potential problem, sim!ply so it can be avoided. It should be noted that beta agonists and even working out increase proteinurea.

I hyped up insulin and AS in the first article in this series and I don't take any of it back. Simply put: this combo rocks! Using these compounds I put on 10lbs in 4days! It wasn't fat or subcutaneous water so it had to be muscle! Okay, it was just intracellular water, but the results are still dramatic to say the least. Three 14IU shots a day keeps my body in a ridiculously powerful state of anabolism. I recommend that 100grams of easily digestible protein be consumed during the 4 hour duration of the drug (while juicing). At this time it can be assumed that every gram will be assimilated. My HCA use is down to every third shot of insulin, and that may be slightly unnecessary. Please note that I am also using captopril which exhibits fat loss characteristics. I have no other big tips to offer, except (I'd) use insulin as much as possible while on a heavy cycle. Since I'm getting gyno while using anti-estrogens, I have to say that the anti-aromatase ability of insuli!n is next to non-existent. I'd like to note that another AS/insulin user was also using GH and still gaining fat, although I don't know what his eating was like.

I now realize that the use of beta-andregenic agonists is useless while on insulin. They decrease insulin sensitivity and increase cortisol levels. Their fat loss abilities are overshadowed by the negative effects on insulin and anabolism. HCA should prevent any responsible use fat gain, making use of these compounds all the more futile. The only time I'd recommend clen and insulin is when coming off a cycle(I obviously don't buy the "clen is not anabolic" theory).

Although nocturnal feedings are effective in keeping positive nitrogen balance, and decreasing the diurnal (daily) morning cortisol rush, they should not be used while using insulin during the day. These nocturnal feedings may prevent insulin sensitivity from improving as much as normal, which would lead to less anabolism and greater fat gain. The use of AS or doing insulin shots only after workouts negate this suggestion.

This potential side effect has been WAY too hyped by the anti-insulin propogandists. The idea of your own pancreas shutting down insulin production due to exogenous use is silly, and requires massive irresponsible use over extended time periods. Using myself as an example, I've been using insulin for 7 months straight. "WHAT?! Why did my pancreas not explode long ago?" You ask. For a simple reason: responsible use. I think that peoples fear of becoming dependant on insulin stems from minor knowledge about the testosterone feedback loop and AS cycles. Another part of this moronic recipe is peoples'ignorance about their own body and that brilliant bullshit anti-insulin propaganda. Quick lesson. Your body(beta cells of the pancreas)produces insulin in response to increased serum glucose levels, specific amino acids etc. As long as you don't shut this mechanism down from exogenous insulin use for long periods of time there should be no pr!oblems(unless you're fucked to begin with). This means that you'd have to use insulin for 12 hours a day(3 perfectly spaced out shots)for over three months while insuring that you are not stimulating endogenous insulin production. Only a moron could do this which makes me wonder why it doesn't happen all the time). Another problem could arise if one uses an insulin shot every day at the same time for months on end. For example if one did a shot upon arising for many months, prior to eating. After a while the body would become conditioned(due to external/internal cues) to not produce insulin at that time. [note:I used morning insulin shots for 4 months without adverse effects] This situation could be easily remedied by tapering down the dosage of insulin over a period of weeks (although I hesitate to make the connection with AS). The bottom line is that using insulin before/after workouts for any length of time will not shut down the beta cells for long enough to cause this !problem. Remember that the beta cells are normally shut do!wn for at least 8 hours a day, while
sleeping, and this happens for 80 years without adverse effect.

Although I despise the anti-insulin propaganda, which I have contributed to in the past, it does have some merit. Personally I wouldn't care about people dying from insulin use, if only it didn't expose this drug in a negative light. I simply see insulin screwups as somebody sticking shit into their bodies that they know nothing about(meaning: it is on 8 thier 8 head).But in my position I have to wonder why the person tried the stuff in the first place. Lately I've been quite curious about peoples'insulin use because, to be honest, the shit just isn't that great! Don't get me wrong I'd never recommend another AS cycle without it, and you'd have to be a moron to spend $8000. on GH without learning the finer points of insulin use...but there's no reason for people to be using this stuff on a "try it and see" basis. Personally I wouldn't let some guy in an article stop me from trying this normally safe (with responsible use) drug, and I would never try to dis!suade anyone who "has to know" that it is like. But seriously, there's no other reason, for anyone not trying to maximize muscle mass, to use this drug. I don't like it but it's the truth, so I have to report it. For me(the genetic loser of the century), insulin doesn't do much without AS. I will always use it as a training aid, but that's only because I've already gone through the bullshit of planning out my body's reaction to the stuff. I also like the fact that I've come to know my body better than I could have without insulin, but that's only because I've had (too) many sugar crashes to help me feel my serum glucose status. To end this depressing section I have to restate that this is not intended as some "life-saving", anti-insulin propaganda. I'm just stating that insulin doesn't do that much (notable exceptions already mentioned) and certainly doesn't deserve all the hype (good or bad). [I think I'm going to cry now.]
Description: This description was taken directly from Brian Raupp's Anabolix Research page since this drug is so dangerous and his description is by far the most comprehensive that I have found on the internet.

Insulin is a hormone produced in the pancreas which helps to regulate glucose levels in the body. Medically, it is typically used in the treatment of diabetes. Recently, insulin has become quite popular among bodybuilders due to the anabolic effect it can offer. With well-timed injections, insulin will help to bring glycogen and other nutrients to the muscles.
In America, regular human insulin is available without a prescription by the name of Humulin R by Eli Lilly and Company. It costs about $20 for a 10 ml vial with a strength of 100 IU per ml. Eli Lilly and Company also produces 5 other insulin formulations, but none of these should be used by bodybuilders. Humulin R is the safest because it takes effect quickly and has the shortest duration of activity. The other insulin formulations remain active for a longer time period and can put the user in an unexpected state of hypoglycemia.

Hypoglycemia occurs when blood glucose levels are too low. It is a commonand potentially fatal reaction experienced by insulin users. Before an athlete begins taking insulin, it is critical that he understands the warning signs and symptoms of hypoglycemia. The following is a list of symptoms which may indicate a mild to moderate hypoglycemia: hunger, drowsiness, blurred vision, depressive mood, dizziness, sweating, palpitation, tremor, restlessness, tingling in the hands, feet, lips, or tongue, lightheadedness, inability to concentrate, headache, sleep disturbances, anxiety, slurred speech, irritability, abnormal behavior, unsteady movement, and personality changes. If any of these warning signs should occur, an athlete should immediately consume a food or drink containing sugar such as a candy bar or carbohydrate drink. This will treat a mild to moderate hypoglycemia and prevent a severe state of hypoglycemia. Severe hypoglycemia is a serious condition that may require medical attention. Symptoms include disorientation, seizure, unconsciousness, and death.

Insulin is used in a wide variety of ways. Most athletes choose to use it immediately after a workout. Dosages used are usually 1 IU per 10-20 pounds of lean bodyweight. First-time users should start at a low dosage and gradually work up. For example, first begin with 2 IU and then increase the dosage by 1 IU every consecutive workout. This will allow the athlete to safely determine a dosage. Insulin dosages can vary significantly among athletes and are dependent upon insulin sensitivity and the use of other drugs. Athletes using growth hormone and thyroid will have higher insulin requirements, and therefore, will be able to handle higher dosages.

Humilin R should be injected subcutaneously only with a U-100 insulin syringe. Insulin syringes are available without a prescription in many states. If the athlete can not purchase the syringes at a pharmacy, he can mail order them or buy them on the black market. Using a syringe other than a U-100 is dangerous since it will be difficult to measure out the correct dosage. Subcutaneous insulin injections are usually given by pinching a fold of skin in the abdomen area. To speed up the effect of the insulin, many athletes will inject their dose into the thigh or triceps

Most athletes will bring their insulin with them to the gym. Insulin should be refrigerated, but it is all right to keep it in a gym bag as long as it is kept away from excessive heat. Immediately after a workout, the athlete will inject his dosage of insulin. Within the next fifteen minutes, he should have a carbohydrate drink such as Ultra Fuel by Twinlab. The athlete should consume at least 10 grams of carbohydrates for every 1 IU of insulin injected. Most athletes will also take creatine monohydrate with their carbohydrate drink since the insulin will help to force the creatine into the muscles. An hour or so after injecting insulin, most athletes will eat a meal or consume a protein shake. The carbohydrate drink and meal/protein shake are necessary. Without them, blood sugar levels will drop dangerously low and the athlete will most likely go into a state of hypoglycemia.
Many athletes will get sleepy after injecting insulin. This may be a symptom of hypoglycemia, and an athlete should probably consume more carbohydrates. Avoid the temptation to go to bed since the insulin may take its peak effect during sleep and significantly drop glucose levels. Being unaware of the warning signs during his slumber, the athlete is at a high risk of going into a state of severe hypoglycemia without anyone realizing it. Humulin R usually remains active for only 4 hours with a peak at about two hours after injecting. An athlete would be wise to stay up for the 4 hours after injecting.

Rather than waiting to the end of a workout, many athletes prefer to inject their insulin dosage 30 minutes before their training session is over and then consume a carbohydrate drink immediately following the workout. This will make the insulin more efficient at bringing glycogen to the muscles, but it will also increase the danger of hypoglycemia. Some athletes will even inject a few IUs before lifting to improve their pump. This practice is extremely risky and best left to athletes with experience using insulin. Finally, some athletes like to inject insulin upon waking in the morning. After the injection, they will consume a carbohydrate drink and then have breakfast within the next hour. Some athletes find this application of insulin very beneficial for putting on mass, while others will tend to put on excess fat using insulin in this way.
Insulin use can not be detected during a drug test. For this reason, along with the fact that it is cheap and readily available, insulin has become a popular drug among the competitive athlete. However, before an athlete attempts to use insulin, he should educate himself and make himself aware of the consequences. One mistake in dosage or diet can be potentially fatal.
Effective Dose: 1 IU per 10 - 20 lbs. of body weight

Street Price: Can be bought over-the-counter for around $15 - 20 / 10 cc. bottle Humulin-R
The Physiological Role of Insulin in the Body: Insulin is a hormone which is manufactured in the pancreas and which has a number of important physiological actions in the body. It is an essential hormone in maintaining the body's blood glucose level so that the brain, muscles, heart and other tissues are adequately supplied with the fuel they require for normal cellular metabolism and normal function. Insulin also plays an essential role in fat and protein metabolism. For example, it promotes transport of amino acids from the bloodstream into muscle and other cells. Within these cells, insulin increases the rate of incorporation of amino acids into protein (amino acids are the building blocks of protein) and reduces protein break down in the body ("catabolism"). These physiological actions probably form the basis of speculation regarding the additional anabolic gains which might be made through the use of exogenously administered insulin.

Normally, blood glucose and blood insulin levels are not both elevated for any extended period of time as these two chemicals influence each other through a feedback system in the body. In the post-absorptive state, the blood insulin concentration tends to decrease during exercise, allowing the blood glucose to be maintained at or above resting levels and to provide increased energy supplies (fuel) to muscle cells. Following a meal, the blood glucose and amino acid levels rise (the absorptive state) and this triggers an increase in insulin release from the pancreas, driving glucose and amino acids from the blood into cells and maintaining the blood glucose level within a certain physiological (operating) range.
Intending users should also be aware that insulin stimulates lipid (fat) synthesis from carbohydrate ("lipogenesis"), decreases fatty acid release from tissues ("lipolysis") and leads to a net increase in total body lipid stores. The development of such increased body fat stores runs counter to the training goals of most body builders, athletes and those seeking to improve their physical appearance.

In striving to become bigger, stronger, more competitive or more physically attractive you should also remember that no matter what you do, your genetic make-up will have an influence on what you are able to achieve. It is important to realize that you cannot look exactly like the role model you admire because you have inherited a different set of genes.
The Glycemic Index Factor: Scientists have discovered that carbohydrate containing foods can be measured and ranked on the basis of the rate and level of blood glucose increase they cause when eaten. This measurement is called the "Glycemic Index" or "G.I. factor". The rate at which glucose enters the bloodstream affects the insulin response to that food and ultimately affects the rate at which this glucose (fuel) is made available to exercising muscles. (2)
Low G.I. foods are those measuring less than 50 on a scale of 1-100. Moderate G.I. foods are those with a reading of 50-70 and high G.I. foods are those measuring 71 or greater on this scale. Pure glucose has a G.I. of 100.
Foods which have a high G.I. produce a rapid increase in blood glucose and blood insulin levels. Examples of such high G.I. foods are potatoes, ice cream, many cereals particularly those with a high sugar content, some varieties of rice (e.g. Calrose) and sweets.
Foods with an moderate G.I. include some brands of muesli, some varieties of rice, white or brown bread, honey and some cereals.
Foods with a low G.I. produce a slower, smaller but more sustained increase in blood glucose levels. Examples of such low G.I. foods are pasta, varieties of high amylose rice, barley, instant noodles, oats, heavy grain breads, lentils, and many fruits such as apples and dried apricots. Low G.I foods are advantageous if consumed at least two hours before an event. This gives time for this food to be emptied from the stomach into the small intestine. Since these foods are digested and absorbed slowly from the gastro-intestinal tract, they continue to provide glucose to muscle cells for a longer period of time than moderate or high G.I. foods, particularly towards the end of an event when muscle glycogen stores may be running low. In this way, low G.I. foods can increase a person's exercise endurance and prolong the time before exhaustion sets in.(2)

High G.I. foods, preferably in the form of liquid foods or glucose drinks of approximately 6% in concentration, can enhance endurance during a very strenuous event lasting more than 90 minutes. ("strenuous" being defined as an athlete exercising at more than 65% of their maximum capacity). Some athletes may prefer food rather than liquid replenishment. Miller(2) suggests glucose enriched honey sandwiches, which have a G.I. factor of 75 or jelly beans, which have a G.I. factor of 80.
Miller suggests that an athlete who is engaged in a prolonged strenuous event should consume between 30 and 60 grams of carbohydrate per hour during the event.

High G.I. foods are also desirable after completing an exhausting sporting or training event when muscle and liver glycogen stores have been depleted, as they provide a rapidly absorbed source of glucose and stimulate insulin release from the pancreas. This insulin in turn stimulates the absorption of glucose into liver and muscle cells and its storage as hepatic and muscle glycogen, optimizing recovery and preparation for the next training or competitive event.

It has been shown that greatest benefit can be had if an athlete consumes these high G.I. carbohydrate foods as soon as possible after an event, preferably within an hour or less. It is further recommended that a high carbohydrate intake be maintained during the next 24 hours. Miller suggests eating at least one gram of carbohydrate per kilogram body weight each 2 hours after prolonged heavy exercise and at least 10 grams of high G.I. carbohydrate per kilogram body weight over the 24 hour period following this exercise.

For these reasons, an athlete who needs to maintain a high level of activity and performance on consecutive days or more extended periods of time should eat large amounts of high G.I. foods. However, a reasonable quantity of low G.I. carbohydrate food should be consumed before an event in order to improve endurance.
A Natural Method of Maintaining an Elevated Blood Insulin Level: Noting the hypothesis that an elevated blood insulin level may be of some advantage to bodybuilders, Fahey and his colleagues (1993) undertook an experiment in which they fed athletes a liquid meal of "Metabolol", which consisted of 13.0 g protein, 31.9 g carbohydrate and 2.6 g fat per 100 ml and provided 825 kJ of energy.

These researchers demonstrated that it is possible with such intermittent feeding during intense weight training to maintain a person's blood glucose at or above resting levels and at the same time, significantly increase insulin levels for the duration of the workout. This suggests a potentially effective and safe non-drug method for achieving a sustained elevation of blood insulin levels.
The authors of this research commented that "theoretically, this could provide a biochemical environment conducive to accelerating the rate of muscle hypertrophy and inhibiting protein degradation." However, the writer knows of no scientific studies which support this theory.

It is also relevant to note that muscle repair and growth begins in the hours and days following heavy exercise. It is doubtful that the use of insulin just prior to a workout will have any anabolic effects over and above natural processes, at this time. However, use of insulin prior to a workout will certainly expose you to much greater risk of serious harm. If you believe it is beneficial to have a higher insulin blood level during workouts, use the natural method outlined here.

Level of Risk Associated with Insulin Use: The use of all drugs carries some risk along with potential or perceived benefits, whether used for legitimate medical reasons or for other purposes. Insulin carries some risk even when used by an insulin dependent diabetic, as demonstrated by the observation that some diabetics run into difficulties with their treatment from time to time and often require assistance to restabilize their medical condition and insulin requirements. If used by a healthy non diabetic person in whom there is no natural deficiency in insulin production or reduced insulin sensitivity and in the absence of medical advice and monitoring, the risks may be substantially increased.

The major risk associated with insulin is a physical state known as hypoglycemia or "low blood sugar". This occurs when the level of glucose in the blood falls below a certain level required for normal body function. If the blood glucose level is substantially reduced below this normal level and if this is not quickly corrected, there is a risk of disorientation, collapse, coma, permanent brain damage and even death. Exercise and reduced food intake decreases the body's need for insulin and increases the risk of hypoglycemia associated with non-medical use of insulin.

It is difficult to provide a quantitative estimate of risk for any drug but on a scale of risk in relation to other non-medical and unsanctioned drug use, the use of insulin in this manner would rank towards the higher end of the scale. If zero equals "no risk" of harm to a person's health and ten equals "extreme risk", the use of anabolic steroids in a non-medical context might rate towards the middle of the scale of risk (particularly in the medium to long term) whilst insulin would rate higher. This level of risk associated with insulin use will depend on a number of factors:
Whether the person is a diabetic or not: non-diabetics and lean healthy people are more sensitive to the blood glucose lowering effects of insulin than diabetics;

Type of insulin: short acting insulin preparations are considerably safer than long acting preparations because with short acting types, it is much easier to avoid hypoglycemia with adequate food intake. With the non-medical use of longer acting insulin preparations, a person is at real risk of experiencing hypoglycemia late in the day, particularly in between meals, during or after exercise and when asleep. Regardless of this advice, some people are in reality using a mixture of short and long acting insulin preparations and exposing themselves to unnecessary increased risk.

Food intake: the type and timing of food consumed, its glycemic index (the glucose elevating effect) and the amount consumed, Body weight, Timing of insulin administration in relation to food intake and exercise.
Individual variation: two different people can respond in a very different way to a given dose of insulin, even if they are of a similar height, weight and other personal characteristics. The fact that a certain dose does not seem to cause a problem for one person does not mean this will be so for another. In addition, the response to insulin will also vary greatly within any one individual over time, according to changes in one or more of the above noted factors.

5-10 Units of a short acting preparation may have little or no observable impact on someone who eats a meal soon before or after but this dose could cause hypoglycemia and collapse in a person who has not consumed adequate food in close proximity to the time when the insulin begins to take effect (insulin starts to take effect within 5-10 minutes if injected by intra-muscular route and in 30-60 minutes if injected by subcutaneous route). Foods with a high glycemic index will maintain the blood glucose level for a short period of time, perhaps an hour or so whilst those with a low glycemic index will provide for more sustained glucose levels.

Risk Reduction Advice: Given the risks of using insulin for non medical purposes, the best advice one can give is not use it in this way. Even the body building magazines such as "Muscle Media 2000" advise: "If you're thinking about using insulin, think twice - it's really risky!"(3) However, if you are not persuaded by this advice and are determined to pursue its use in the hope of achieving some additional anabolic or other gains, you should take the following precautions:
Consider using the natural method of raising your blood insulin level during workouts by consuming glucose containing fluids at intervals during exercise. These fluids may have a protein sparing effect and at the same time, will help maintain keep your blood glucose and blood insulin levels. However, if you decide to use insulin, you should consider the following advice:
Always use insulin in the presence of someone else who knows about and understands the exact risks of using insulin in this manner, so they are able to act quickly and appropriately should something go wrong;

Always use a sterile needle and syringe every time and a clean injecting technique (e.g. don't touch the needle or the skin where you are going to inject, with your fingers and don't breathe on or cough over the injection site before or after injecting.)
Be aware that 1.0 ml of insulin contains one hundred International Units (100 IU), 0.1 ml of insulin contains ten (10) IU and 0.01 ml contains one (1.0) IU. So take care in measuring out your insulin, It is very concentrated!
Note that 0.01 ml is the volume contained in the space between the smallest graduated markings on a 1.0 ml Terumo diabetic syringe;

Inject by the subcutaneous route (injecting just under the skin and preferably in the abdominal area or outer part of the upper thigh), not intramuscularly or intravenously as using the latter routes can lead to a rapid rise in blood insulin level and a sudden hypoglycemic episode;
Alternate your injection sites in order to minimize tissue damage ("lipoatrophy" or "lipohypertrophy";
Always use a short acting, "regular" insulin (e.g. Actrapid, Insulin Neutral, Humulin R, Hypurin Neutral) rather than a longer acting insulin preparation (e.g. Semilente, Lente or Ultralente);

Use a human insulin rather than an animal insulin preparation if possible (there is little animal insulin available now);
Start with no more than 5 IU (0.05 ml) of this short acting/ regular insulin preparation and increase the dose gradually over a period of one week, to a dose no higher than 20 IU (0.20 ml) per day. Doses above this will expose you to progressively greater risk and most body builders who use insulin believe there is no advantage in taking doses higher than this. Anecdotal evidence amongst bodybuilders suggests increased doses leads to excess bodyfat accumulation.

The writer would caution against users falling into the trap of thinking: "If 20 units is good, 40 units will be twice as good" or "Joe says he injected 20 units and it didn't affect him, so it will be safe for me to inject 30 or 40 units". All drugs have a therapeutic dose range and above this, may be toxic or even lethal. If you are not diabetic, your body does not require additional insulin and there is no therapeutic range for you. In addition, people are different and often respond differently to drugs. An individual may also respond differently to the same drug in the same dose at different times, depending on a wide range of factors such as their general health, alcohol or other drugs taken, food eaten, exercise undertaken before, during or after drug administration and so on.

Don't use a medium or long acting insulin in the middle or latter part of the day, as you may very well experience a hypoglycemic attack whilst you are asleep. If this happens, neither you nor anyone else will be aware of or able to respond to your urgent need for glucose, in order to prevent possible serious harm.
Dietary Guidelines:
Close attention to diet is extremely important in people using insulin, whether this is for legitimate medical purposes or for other reasons. You can reduce your risk by consuming an adequate amount and mixture of high and low G.I. carbohydrate foods and drinks immediately after using insulin and at regular intervals (every 2-3 hours) throughout the day.

High G.I. carbohydrates (e.g. sweets, soft drinks and ice-cream) will raise your blood sugar quickly and prevent early hypoglycemia. 

Low G.I. carbohydrates (e.g. white pasta, high amylose rice, softened whole grain breads and instant noodles) are metabolized more slowly and will keep your blood glucose level up over a more extended period of time, when the medium acting insulin preparations begin to take effect; 55-65% of your total daily energy intake should be in the form of carbohydrates, 15-20% as protein and ~20% as fat. You should seek advice from a dietitian about your daily requirements but most heavy training athletes need to consume between 3,000 and 5,500 Calories per day (depending on the sport and level of training) and between 450 and 800 grams of carbohydrate each day. If you are a body builder who weighs 100 kg and your total energy requirements are calculated to be 4,000 calories/ day, you should aim to eat approximately 570 grams of carbohydrate each day. If your total energy requirements are calculated to be 5,000 calories/ day, you should aim to eat approximately 720 grams of carbohydrate each day.

Divide up your calculated total daily carbohydrate requirements over the course of your waking hours and consume frequent carbohydrate meals throughout the day. For example, if you require 4,000 calories per day, you might eat six meals of 650-700 Calories at 2-3 hour intervals.

This would mean eating approximately 90-100 grams of carbohydrate each meal, which for example you will obtain from 7 slices of bread alone or 4-5 slices of bread with 1 ??? tablespoons of honey or 500 ml of Sustagen or 3 slices of bread eaten with a 450 gram can of baked beans. You can refer to the attached food tables to work out your own requirements according to your own food preferences. You will need to choose a mixture foods from this table with a high, medium or low G.I., according to the nature and level of the training you are doing.

Once again, the writer would strongly recommend that you consult a dietitian who has an interest and experience in sports nutrition, in order to assist you design a dietary program which is best suited to your training goals and needs and to your food preferences. It is equally important that you find a dietitian with whom you feel comfortable telling about your insulin or other performance enhancing substance use, as their advice may otherwise be less than useful to you. If your dietitian does not know about and does not take such substance use into account, their advice may even add to the dangers associated with this substance use.

Always have a source of glucose or other high G.I. food ready at hand, in case you should begin to experience the symptoms of hypoglycemia. If this does occur, you should take this glucose or food without delay. You should eat or drink 15-20 grams of carbohydrate to begin with, which is contained in ~ 2 slices of white or brown bread, two glasses of milk, a half glass of soft drink, a tablespoon of honey or six jelly beans.

Other examples of glucose or other high Glycemic index carbohydrate preparations which you can use include: glucose tablets, glucose powder mixed in a small volume of water, barley sugar, or other sweets or if these are not immediately available, a sugar containing cordial, soft drink or plain sugar dissolved in water. This should be followed by an adequate low Glycemic index carbohydrate meal to prevent further hypoglycemia since the insulin levels are likely to remain high for some hours after the high Glycemic index carbohydrates are used up (metabolized) in the body.
The Crucial Role of the Friend or Peer Observer: If you are going to use insulin, it is essential that you have a friend or peer observer remain with you in case you experience problems. This person really needs to be with you for the whole time while the insulin preparation used is working.
Be aware that the risk of hypoglycemia occurs not at the time of insulin injection but rather, when the insulin starts to take effect. The risk will be greatest when your insulin blood level nears or reaches its highest level, usually 30-60 minutes afterwards if a short acting insulin preparation is used (by subcutaneous injection) and up to 20 hours later if a long acting insulin is used.
Consider giving this paper to the person who is going to be with you when you use insulin, so they are aware of the things to look out for and what to do if you should experience a hypoglycemic reaction. The following instructions are for a peer observer or other person who may find you experiencing difficulty as a result of overdosing on insulin or any other drug or combination of drugs:

Instructions for the Peer Observer Assisting an Insulin User: If the person who has used insulin states that they are beginning to feel any of the following symptoms: faintness, dizziness, thirst, hunger, nausea, weakness, sweating, or if you observe that they have become: confused, disorientated, sweaty, drowsy, you should immediately give them glucose or a sugar containing drink or food as mentioned above. However, you should not try to give a person food or fluids if they are so drowsy that they are unable to swallow it, since they will be at risk of accidentally breathing in (aspirating) this food or fluid. If they cannot readily respond to your questions or your commands, you should assume they are unable to swallow anything safely.
If the person loses consciousness, you should place them in either a "lateral" or "coma" position, tilting the head fully back and jaw forward, in order to ensure an open airway and protect them from possible aspiration. Keep them in this position while medical assistance is being sought.

You should then immediately call an ambulance by dialing "911", to get them to a hospital without any delay whatsoever. When the ambulance arrives, you should tell the ambulance officers exactly what the person has taken and what you have observed so the correct treatment can be provided promptly. This is essential as the person's life may be at stake.
Severe hypoglycemia or a combination of alcohol and other drugs, particularly drugs which suppress the central nervous system, can cause a person to stop breathing and their heart to stop beating. Remember, it only takes a few minutes for someone to suffer permanent brain damage or to die, once they stop breathing.

There are several common signs which may be apparent in someone who has overdosed from one or a combination of drugs. These include: very slow or shallow breathing or no breathing at all (listen close to the person's mouth and nose for breath sounds and look for movement of their chest wall); snoring or gurgling breathing in someone who is asleep; blue lips and fingernails (caused by lack of oxygen); no response to shaking, calling their name or pain (try pinching their earlobe and pressing down hard on one of their fingernails with a pen); very slow, faint pulse or no pulse at all.

What To Do in the Event of an Overdose: stay calm; squeeze earlobe/ press on fingernail of person in an effort to arouse them; if person responds, try to walk them around; if no response, check person's breathing and pulse; if unconscious but breathing, place in lateral or coma position; call an ambulance by dialing 911, they will give you advice on what to do, which might include: if there is a pulse but the person is not breathing, start artificial respiration, otherwise known as Expired Airways Resuscitation (EAR), without delay; if no pulse, start cardio-pulmonary resuscitation (CPR); stay with the person, continuing to administer artificial respiration or CPR until the ambulance arrives. Keep them in the lateral or coma position if they are breathing on their own; tell the ambulance officers exactly what they may have taken and what you have observed.
The writer would like to emphasize once more that this paper should in no way be construed as an encouragement to people to use insulin in an effort to increase muscle mass, sports performance or appearance. Rather, it represents a pragmatic attempt at providing harm reduction advice to people who choose to take the risk of using insulin in this way, despite their knowledge of those risks.

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