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A study by researchers at Western Washington University-Bellingham found that NCAA football players taking ZMA nightly during an eight-week spring training program had an increase in both IGF-1 levels and testosterone, while those taking a placebo had a drop in both. In summary, AAS misuse and toxicity requires an interprofessional team approach, including physicians, specialists, specialty-trained nurses, and pharmacists, all collaborating across disciplines to achieve optimal patient results. According to a Finnish population-based study, the risk of anabolic steroid and testosterone abusers dying prematurely was. One survey-based study revealed that while women taking steroids increased lean body mass, increased strength, and decreased fat mass, they also experienced a deepened voice, increased facial hair, increased aggressiveness, clitoral enlargement, menstrual irregularities, and breast atrophy.

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