Tour de France testosterone flap shines new light on Boston's expert in hormone's surprising, softer side
Dr. Shalender Bhasin stands just under 6 feet tall, with a wiry body and lean shoulders that have trouble filling out his sports jacket.
His handshake borders on firm, though you wouldn't wince at the greeting. His voice is subdued.
``I've never been to a gym in my life," says Bhasin, one of the world's leading authorities on a hormone synonymous with muscle and machismo. ``I oversee an exercise lab, but that's it."
Bhasin, 52, has spent most of his career studying testosterone, and while much of the world associates the chemical with muscle-bound bodybuilders and athletic doping scandals, he has dedicated his life to studying testosterone for its softer side -- potential therapeutic uses for elderly, frail, or diseased patients.
A resident of Back Bay, Bhasin is chief of endocrinology, nutrition, and diabetes at Boston Medical Center and a professor of medicine at Boston University.
But it was the controversy over last month's Tour de France winner, Floyd Landis, that shoved Bhasin into the international public spotlight. Landis, first cheered for following in the path of seven-time Tour champion Lance Armstrong, was quickly caught in a scandal when post race testing showed elevated testosterone levels.
As the Landis story broke, Bhasin says he was inundated with calls from reporters from all over the world who were looking for an expert source on testosterone.
``My voice mail filled up very quickly," he says. ``Luckily, the day the story came out, I was in meetings all day."
Bhasin says he tries not to do too many interviews, although he's as accommodating as possible without letting his calendar fill with them. The questions he is asked are typically about muscle growth in athletes, not about testosterone therapy -- his life's work.
``The abuse issues clearly detract attention from the therapeutic issues," Bhasin says.
There is limited funding for his research, he says, because, as a society, ``We're ambivalent to how testosterone can help."
Bhasin is investigating how a certain type of testosterone gel might help muscle strength and function in the elderly. His study is looking for male subjects over the age of 65 who have trouble walking more than a few blocks or up stairs.
``Frailty in the elderly is a huge public health problem," Bhasin says. ``It's a problem for the patient and their families. . . . The cost of lost quality of life is incalculable. There's a huge societal benefit to developing anabolic therapies."
That potential public health boon is what makes Bhasin protective of his professional time.
``If I don't keep media appointments in perspective, they can become very distracting," he says. ``I have to try to remember what our primary mission is."
Bhasin says he understands how interesting the steroid scandal stories are, so he's not overly angered or saddened that the questions he fields are about athletes, but he's also a bit frustrated that the softer side of testosterone isn't given fair play.
``The steroid scandals make it seem like testosterone is not a legitimate area for research," Bhasin says.
In medical circles, though, Bhasin is a celebrity -- without the muscles or home-run records -- for an article on testosterone he published in the New England Journal of Medicine in 1996.
The article, ``The Effects of Supraphysiologic Doses of Testosterone on Muscle Size and Strength in Normal Men," outlined how testosterone injections made healthy men stronger and increased their muscle size.
``It was the definitive and landmark study demonstrating that testosterone acts as an anabolic steroid," says Dr. Joel Finkelstein, 51, an associate professor of medicine at Harvard Medical School. ``That article was very important because it proved for the first time that testosterone positively was an anabolic steroid. Although it was not a surprise to some people, it had never been done before."
Prior to that study, Bhasin says, some athletes had been taking steroids because of shared impressions that doing so helped build muscle. Many leading endocrinologists rejected that idea, attributing any extra muscle growth to the placebo effect.
``I was desperate to look into it," Bhasin says. ``I was really struck by the diversion and polarity of views on this topic. Having been swayed by the giants in the field, I wanted to prove it. . . . I was the most surprised that the data was so clear in a very remarkable way; that there was an obvious increase in muscle mass and the additive effects of androgens."
Since publishing that study, Bhasin says, he's been called virtually every summer by the news media to answer questions about the latest steroid scandal. He doesn't expect the scandals -- or calls -- will stop, since they are a product of human nature.
``The Landis story wasn't a new story," Bhasin says. ``Seemingly every summer we create a god out of one of our athletes and then we shoot our god. This has been our way since the beginning of time.
``When God created men and women, he created this schizophrenia in our personalities. We struggle so much to achieve greatness, to rise above the mediocrity and find meaning for our existence, and yet we are so frail. We want to see the records broken and we want our athletes to do wonderful things, but we are the first to bring them down."
Despite his focus on therapeutic applications of testosterone, Bhasin is admittedly fascinated by athletes' desire to use testosterone to boost performance. He has spent a great deal of time speaking about how steroid use fits into a philosophy of life and how it is directly related to the human desire to achieve greatness.
``In many ways, we are all struggling to rise above mediocrity, so it's not a surprise, but it's always been a source of interest to me," Bhasin says. ``We all anguish daily on whether we're doing the right thing and at the same time we hope for such greatness. What is it that makes us willing to sacrifice so much to achieve?"
Bhasin typically gets up around 3:45 in the morning to think and work, wrestling with issues of metaphysics, philosophy, and the existence of God. He does his best thinking in the morning, he says, and he'll often arise with thoughts of his research swirling through his mind.
``It's amazing; we can't keep up with the pace of what's going on in his head," says Ana Mercurio , administrative director for endocrinology, diabetes, and nutrition at Boston Medical Center. ``He's constantly thinking ahead and it's overwhelming sometimes to keep up with the pace. With him, the possibilities are endless. I've gotten e-mails from him that he sent at 4 o'clock in the morning."
The father of two grown children, Bhasin spends much of his spare time reading about the players in history who've achieved greatness after humble beginnings, such people as Mahatma Gandhi and Alexander the Great.
``I'm very fascinated with
Bhasin will only admit inferentially to wanting to achieve a level of greatness for himself.
``People will probably forget about this interview and these pictures in 48 hours," Bhasin says. ``In 3,000 years, this story won't be about me, but in the end the fact is, if I find some lasting truth . . . people might remember what I've done."
Ryan Murphy can be reached at ciweek@globe.com.
Testosterone's softer side
Dr. Shalender Bhasin , chief of endocrinology, diabetes, and nutrition at Boston Medical Center, says that beyond the highly publicized abuses of testosterone, there is much potential good in the therapeutic use of the hormone.
Among the benefits he cites, testosterone can:
help maintain a metabolic balance
promote muscle growth in older, frail, or diseased patients
enhance bone health
positively influence sexual health
