Perth cardiologists are alarmed by a rising number of young and middle-aged men with heart damage after using amphetamines and body-building supplements.
Several doctors have told of their deepening concerns about seeing patients, some aged in their 20s, on their way to heart failure requiring a transplant, after using amphetamines or sports supplements ordered over the internet from China.
Royal Perth Hospital cardiologist Lawrence Dembo said amphetamine use was worrying but a bigger problem on the horizon was the growing use of poorly regulated sports supplements by men.
While there have been estimates of Australians spending more than $100 million a year just on protein powders, experts say the market in imported vitamin and protein supplements has surged unchecked.
"The biggest rise in the sport demographics is the 40 to 60-year-olds doing endurance events," Dr Dembo said. "It's massive and they're pulling in all these drugs and supplements from China.
"If you take a bunch of men aged 30 to 50 coming into Royal Perth for anything and you ask if they take anything, it's a frightening percentage - I'm guessing it's more than 70 per cent.
"It means most of the guys you see heading off to the gym are using them."
Dr Dembo said anabolic steroids and body-building products could damage the heart by producing thick muscle and increasing bad cholesterol.
Heart failure specialists saw only the tip of the problem, when people became so sick they needed to be in intensive care, but the numbers were increasing.
"Getting better is simple, by not taking the pills, but most of them say they're not willing to do it," Dr Dembo said. "It doesn't matter if you might have a heart attack, so long as you look good.
"Smart young men in their 20s come in with their parents and they say straight out that they're not going to stop taking these things.
"When you look at how many are taking them, it's terrifying."
Cardiologist and Heart Foundation board member Michelle Ammerer said amphetamines could cause cardiomyopathy, or damaged heart muscle.
"It's more than just from having a fast pulse, it ends up stuffing the heart muscle so it can't pump, and you end up seeing really severe and terrible heart dysfunction in young people," she said. "Cardiologists in Perth are concerned that there seems to be an increasing problem in WA."
Dr Ammerer said while damage could be reversed by coming off the drugs early enough and with standard heart failure treatment, some patients were left with permanent damage.
"We didn't see this much when amphetamine use wasn't so prevalent but some cardiologists are seeing these types of patients every week now," she said.
"People don't seem to understand they can do damage to their heart and face a shortened life span. And we're seeing this sort of damage in people in their 20s."