A Primer On Self-Medication!

The intent of this article is to discuss some of the issues involved in self-diagnosis and self-medication and ways to improve the successful use of medication. No judgment is made of the application and use of prescription medication in the process.

Self-medication is considered the treatment of health issues with safe and effective medication designed for use without medical supervision1. Self-medication is often associated with non-prescription or "over-the-counter" (OTC) medicines as compared to prescription products available under a doctor's directive.

There are many health conditions that can be treated with self-medication. They range from acne to cholesterol lowering to male pattern baldness. In the United States, the Food and Drug Administration (FDA) is responsible for determining which medications are to be administered only from a physician and which medications the general public can use through self-medication.

Often, as data are generated after a prescription medicine has been in use, the FDA will approve it for OTC use. Rogaine, for example, was initially available by prescription only.

Prescription medicines are designated for use only after physician consultation because of the safety issues associated with the medicine. The safety issues can include toxicity, harmful side effects, method of use, or addictive nature of the medicine.

The sports world, serving as a reflection of society, is filled with self-diagnosis of adverse health conditions and self-medication. The rampant use of pain relievers and performance enhancing substances indicate significant acceptance and use of self-medication.

Bodybuilding falls into this realm of significant self-diagnosis and medication use; and often extends to the use of prescription medicine. Part of this acceptance may stem from the number of pills and potions that are taken on a daily basis to promote growth, so a little more isn't a problem.

The intent of this article is to discuss some of the issues involved in self-diagnosis and self-medication and ways to improve the successful use of medication. No judgment is made of the application and use of prescription medication in the process. Potential legal issues are not discussed.

Degrees Of Use

People from all walks of life are more involved in their health management programs today than they were in the past. Involvement includes identifying and understanding health conditions, potential treatment options and potential side effects. For minor ailments and injuries, the majority of individuals use a "wait and see" method of assessment and treatment.

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These ailments can range from a case of the sniffles to a sprained ankle. OTC medicines and treatment will normally be applied. The vast majority of the population has self-medicated using this type of scenario.

One of the drawbacks of self-diagnosis and self-medication is the delay in seeing a doctor. This delay can allow conditions to worsen or give diseases time to incubate. However, the converse must also be considered, relying on a physician for all ailments is also problematic. The American medical system is one of the leading causes of death in this country with misdiagnosis and infection being two significant causes2.

Additionally, there is a rise in the number of people becoming addicted to prescription medicines. Painkillers are the leading class of drugs for this addiction3. These items must be considered given the amount of time, effort and pain we athletes endure in pursuit of our goals.

What needs to be examined and considered for the weight-training athlete is:

  1. How much reliance is placed on accurate self-diagnosis?
  2. When you should seek a medical professional?
  3. How valid is the information and advise provided by others for prescription and non-prescription medication?

It seems practical to diagnose your own health problems. For the medical professionals, doctors themselves, over half thought that self-prescription was ethical4. The main reason cited was convenience, given their time constraints. If a doctor can self prescribe, what prevents individuals that are highly involved in the daily maintenance and understanding of their body from self-prescribing medicine?

Is there not a constitutional right to the pursuit of happiness that would include using whatever substances/treatments necessary for taking care of oneself? Isn't educating the public on adverse health conditions one of the reasons for all the drug advertising?

Another issue is the need for self-diagnosis and medication when it is the only option available. This is often the case for students, the underinsured and the uninsured. The ability to see a medical professional is often a last resort used only for serious medical conditions. For more routine ailments, many are forced to rely on their own evaluation and information provided by others.

It takes some effort to get an accurate self-diagnosis. You must assess your health problem, consider any pre-existing conditions, know what the problem looks, feels, smells, and sounds like, and be able to describe all in detail.

Additionally, the indications should be compared to what your "normal" is. Chemical interactions should also be considered. The prescription and OTC medicines or supplements you take on a regular basis may be incompatible with those recommended for treatment.

Moving beyond the minor ailments, there is the case for self-diagnosis of more severe indications and health conditions. Some of these indications and conditions are captured in self-diagnosis databases while others are not. Key to successful use of these databases is the "terminology" and symptoms that describe the ailment or injury. This is where the databases differ significantly.

Databases, listed by my preference, that offer a self-diagnosis service include:

One of the leading conclusions from these databases is the recommendation to see a doctor as symptoms increase in severity or complexity. One of the issues making headlines lately has been the development of "cyberchondria" from using these and other health information sources. British researchers found that Internet users are often incorrectly performing self-diagnosis and presenting false information to physicians. The misdiagnosis stemmed from misleading or vague advice, and results in unnecessary treatment5.

Drug interactions are another issue that is generally addressed by doctors and pharmacist, but rarely by the public when they self medicate. There will always be potential interactions with chemical in our bodies from all sources: medications, supplements, food, or out of our natural environment. I found Drug Digest, a very useful resource for checking and understanding these interactions and recommend its use. The site covers a very wide range of drugs, supplements, and food chemicals.

You should seek medical attention for the following ailments or conditions:

  • A head injury with loss of consciousness.

  • A cut that does not stop bleeding.

  • A potential bone fracture.

  • A soft tissue injury that doesn't improve after 48 hours.

  • Persistent or reoccurring "flu" symptoms.

There are other reasons and times to forgo reliance on self-diagnosis and see a medical professional.

These times and circumstances include:

  • Placating Self-Doubt - if you are not sure of yourself, the information available, symptoms, or treatments (particularly for disease).
  • Garnering Support Of Family Members - at times it is tough to convince others that you have figured out your problems and are taking the appropriate actions.
  • Getting Better Medical Buy-In - doctors often believe and respect individuals taking more responsibility for their health and will attempt to fulfill your diagnosis and treatment wishes to a greater extent. For example, roughly 25% of respondents in a 2002 survey, asked their doctor for a specific brand of drug, and 69% of those patients ultimately received a prescription for that drug6.
  • Lacking Improvement - may indicate an insufficient self-diagnosis or more severe ailment.
  • Obtaining Appropriate Medicine - the best or only viable treatment solution may require prescription medicine, necessitating a visit to the doctor.

Relying On Others

Posing questions on the Internet or to the training and chemical "gurus" is a modern means of circumventing seeing a physician. The gurus and doctors have seen a lot of conditions and indications and generally have a good understanding of treatment methods available. For issues stemming from use of performance enhancing substances, doctors are generally conservative in their diagnosis and treatment.

For initial use of performance enhancing substances, physicians generally will not prescribe medication for conditions other than those the FDA has approved. Insurers are more apt to scrutinize medical conditions and prescribed treatments as health care costs escalate. Additionally, most physicians are not up-to-date with the latest prohormone, prosteriod, supplement or even herbal products available and will often not recommend their use.

For the currently legal performance enhancing substances, read as much as possible before you use the products because many can disrupt normal hormonal balance and have side effects. Use of prescription medication for physique enhancement may require one to illegally obtain them on the "black market," obtain the medication from foreign sources, purchase and use product of unknown quality and purity, or seek "research" or veterinary chemicals.

You can find plenty of information on obtaining and using these substances from various Internet forums. Do your research before you seek and use products obtained through these sources, know what to expect and what effects may be indicating problems with the treatment or substance.

With all this information and options you should still have questions. How much trust do you put in your general practitioner that only rarely sees a well-conditioned athlete? A medical specialist in this field, such as an endocrinologist? An anonymous source on the Internet? An athlete or source that has been linked with similar scenarios to yours? A buddy at the gym?

As often recommended for the general population, it is usually good to get a second opinion. A second opinion should be part of your decision-making process if you are going to self-medicate. Examine which treatment options are available, what symptoms they are recommended for and what interaction they may have with other treatment options.

Are there individuals out there that will follow advice blindly based on what a discussion board member or even what a pro is using? I think the answer is yes. Look at all the advice and/or critiquing sought on someone's first cycle of performance enhancing substances.

How good is that advice and is it reliable? Use your own judgment, most advisors will have some practical experience but few will have a medical education or scientific background. Gather as much information as possible and read the instructions and labels that are provided with the substance.

Improving Your Success

I hit on some points regarding self-medication and ways to put things in action for the weight-trained athlete. I believe that you must look at both the injury/disease perspective as well as the all performance enhancing substances including supplements, prescription medicine, prosteroids, prohormones, and herbal mixtures. Your application of self-diagnosis and self-medication will be enhanced if you follow some general principals.

For injuries and diseases:

  • Seek qualified medical evaluations for serious medical conditions
  • Perform self-diagnosis quickly after the onset of symptoms
  • Ask yourself the same questions you would like to ask, and be asked from, a doctor
  • Note all of your conditions
  • List what products you are currently taking
  • Work through one or several databases for complicated conditions
  • Select a treatment option
  • Read and adhere to instructions
  • Start your treatment process
  • Take the appropriate dosage at the appropriate intervals
  • Observe your reactions

For performance enhancing substances, consider the guidelines above and also:

  • Note your current conditions and the regime that will be followed.
  • Consider a blood test to establish a baseline.
  • Have a list and maintain awareness of expected biological response (both positive response and side effects).
  • Realize that many of these substances are addictive (physically or psychologically), and that addiction can lead to abuse. Know the warning signs for addiction.
  • Establish criteria for discontinuing use, either a pre-planned date or when certain conditions appear.
  • Read and adhere to the instructions and recommendations for use of the substance.

As stated in the opening, this is a primer on self-medication and discusses how to improve your use of substances that enhance your performance. If you are to go beyond use of OTC products, you should have some guidelines for there use. Consider the questions posed earlier and determine how valid your sources of information and advice are.

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Don't follow any advice blindly and ensure you maintain awareness of the signs your body is signaling to you. If you are self-diagnosing and self-medicating, understand the risk you are taking and the need to continually monitor your health. Finally, seek a medical professional when signs and symptoms increase in severity or meet the criteria mentioned earlier.

How Likely Would You Be To Self-Medicate Versus Go To A Doctor?

Very Likely - I would rather fix myself than trust a doctor.
Somewhat Likely - It depens on if I know what is wrong with me.
Very Unlikely - A doctor would know better than I would.


  1. World Self-Medication Industry, http://www.wsmi.org.
  2. Null G., et.al., Death by Medicine. 2003.
  3. Ashbridge Amy L., Prescription-drug abuse on rise, Daily Star, July 10, 2004.
  4. Earle D. Most Doctors consider self-prescribing ethical, Reuter's Health, Oct 4,2003. Associate Press Newswire, Internet health advice can bring on 'cyberchondria', study shows, October 3, 2004.
  5. Kaiser Network Daily Report, Nearly One-Quarter of Patients Ask Doctors for Brand-Name Medications, According to FDA Study, Apr 15, 2002.
  6. Kaiser Network Daily Report, Nearly One-Quarter of Patients Ask Doctors for Brand-Name Medications, According to FDA Study, Apr 15, 2002.