Joyner, who won three gold medals at the 1988 Seoul Olympics (in the 100m, 200m and the 400m relay races) never tested positive for performance- enhancing drugs, and always denied that she took any. That contrasts with the Canadian sprinter Ben Johnson, who at the same games tested positive for steroids and was stripped of his medals, and had his world-record 100m time struck off.
Yet Joyner's sudden death was highly unusual for an otherwise fit person who had not been ill. Without some inherited defect, the most likely causes of heart attack in young people are an overdose of drugs, and the after-effects of substances taken earlier in life. She had a heart seizure two years earlier; this one was fatal.
Rivals were suspicious of Joyner's rapid progress between 1986 and 1988 because they noted physical changes in her and astonishing improvements in her track times. Some commentators are now saying she used drugs such as anabolic steroids to help win.
Anabolic steroids were not intended for athletes; quite the reverse. They are synthetic compounds that resemble testosterone, the male sex hormone. They were developed in 1935 when one team of chemist in Holland and two in Germany submitted papers on the synthesis of male hormones.
They were initially used for various therapies - including hypertension, arterial disease, anaemia, male impotence, female menopause, and, more usefully, in treating breast cancer. But anabolic steroids found perhaps their most valuable use following the Second World War, when they were used to restore the body weight of survivors of concentration camps. Nowadays they are used to help men infected with HIV to fight off the muscle-wasting that follows their falling levels of testosterone.
Athletes spotted the usefulness of steroids in the Fifties; now the black market for amateur and professional athletic use is thought to be worth more than pounds 625m annually.
"Steroids" are simply a general class of chemicals. What athletes want is the "anabolic" element, because that sort of chemical builds muscle by increasing protein synthesis. But there are important side effects. Taken during puberty, they prevent proper bone growth. In men, sperm production falls. Female users develop a deeper voice, and get acne - both changes that were seen in Joyner (she wore heavy makeup to disguise the acne). It causes baldness, dangerously rapid heart rate, kidney stones, and liver tumours.
There are also psychological effects - including feelings of aggression or anxiety - and the risk of addiction, while withdrawal causes weight loss which the addicted user will feel required to put back on, probably with the same drugs.
Among the long-term effects, it is known that if the user's blood pressure and cholesterol levels change, the risk of heart disease and heart attack increases, as does that of cancer. It may be impossible to know the root cause of Joyner's death, but the circumstantial evidence is strong that drugs of some sort were involved.Reuse content