Health Care and Steroids

With the recent news about professional athletes using steriods, many Americans wonder how these drugs affect your health. The reports about Alex Rodriguez using steroids early in his career has made front page news this month. According to the National Institutes of Health (NIH), Anabolic-androgenic steroids (AAS) are manufactured substances related to male sex hormones (e.g., testosterone). “Anabolic” refers to muscle-building and “androgenic” refers to increased male sexual characteristics. “Steroids” refers to the class of drugs. These drugs can be legally prescribed to treat conditions resulting from steroid hormone deficiency, such as delayed puberty, but also body wasting in patients with AIDS and other diseases that result in loss of lean muscle mass. Some people, both athletes and non-athletes, abuse AAS in an attempt to enhance performance and/or improve physical appearance. AAS are taken orally or injected, typically in cycles of weeks or months interrupted by shorter resting periods (this is referred to as “cycling”). In addition, users often combine several different types of steroids, a practice referred to as “stacking.”

According to ESPN, Alex Rodriguez met head-on allegations that he tested positive for steroids six years ago, telling ESPN on Monday that he did take performance-enhancing drugs while playing for the Texas Rangers during a three-year period beginning in 2001. Rodriguez's admission came 48 hours after Sports Illustrated reported that Rodriguez was on a list of 104 players who tested positive for banned substances in 2003, the year when Major League Baseball conducted survey tests to see if mandatory, random drug-testing was needed in the sport. Rodriguez tested positive for testosterone and Primobolan, an anabolic steroid.

The immediate effects of AAS in the brain, as reported by the NIH, are mediated by their binding to androgen and estrogen receptors, which can then shuttle into the cell nucleus to influence patterns of gene expression. Because of this, the acute effects of AAS in the brain are substantially different from those of other drugs of abuse. The most important difference is that AAS are not euphorigenic, meaning that they do not trigger rapid increases in the neurotransmitter dopamine, which are responsible for the “high” that often drives substance abuse behaviors. However, long-term use of AAS can eventually have an impact on some of the same brain pathways and chemicals—such as dopamine, serotonin, and opioid systems—that are affected by drugs of abuse. Considering the combined effect of their complex direct and indirect actions, it is not surprising that AAS can affect mood and behavior in significant ways. Taken together, the preclinical, clinical, and anecdotal reports suggest that steroids may contribute to psychiatric dysfunction.

According to the NIH, research shows that abuse of anabolic steroids may lead to aggression and other adverse effects. For example, many users report feeling good about themselves while on anabolic steroids, but extreme mood swings can also occur, including manic-like symptoms that could lead to violence. Researchers have also observed that users may suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility. The potential for AAS abusers to become addicted is consistent with their continued abuse despite physical problems and negative effects on social relations. Also, steroid abusers typically spend large amounts of time and money obtaining the drugs, which is another indication of addiction. Individuals who abuse steroids can experience withdrawal symptoms when they stop taking AAS, such as mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and steroid cravings, all of which may contribute to the need for continued abuse. One of the most dangerous withdrawal symptoms is depression, because, when persistent, it can sometimes lead to suicide attempts.

Steroid abuse can lead to serious, even irreversible health problems according to the NIH. Some of the most dangerous among them include liver damage, jaundice (yellowish pigmentation of skin, tissues, and body fluids), fluid retention, high blood pressure, increases in LDL (bad cholesterol), and decreases in HDL (good cholesterol). Other reported effects include renal failure, severe acne, and trembling. In addition, there are some gender- and age-specific adverse effects:
1.) For men—shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer.
2.) For women—growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
3.) For adolescents—stunted growth due to premature skeletal maturation and accelerated puberty changes; adolescents risk not reaching their expected height if they take AAS before the typical adolescent growth spurt.

In addition, people who inject AAS run the added risk of contracting or transmitting HIV/AIDS or hepatitis, which causes serious damage to the liver, according to the NIH. There has been very little research on treatment for AAS abuse. Current knowledge derives largely from the experiences of a small number of physicians who have worked with patients undergoing steroid withdrawal. They have learned that, in general, supportive therapy combined with education about possible withdrawal symptoms is sufficient in some cases. Sometimes, medications can be used to restore the balance of the hormonal system after its disruption by steroid abuse. If symptoms are severe or prolonged, symptomatic medications or hospitalization may be needed.

But doctors never prescribe anabolic steroids to young, healthy people to help them build muscles according to the National Institute on Drug Abuse (NIDA). Without a prescription from a doctor, steroids are illegal. Steroids do have legitimate medical uses. Sometimes doctors prescribe anabolic steroids to help people with certain kinds of anemia and men who don't produce enough testosterone on their own. Doctors also prescribe a different kind of steroid, called corticosteroids, to reduce swelling. Corticosteroids are not anabolic steroids and do not have the same harmful effects. There are many different kinds of steroids. Here's a list of some of the most common anabolic steroids taken today: anadrol, oxandrin, dianabol, winstrol, deca-durabolin, and equipoise.

The NIDA reports that some steroid users pop pills. Others use hypodermic needles to inject steroids directly into muscles. When users take more and more of a drug over and over again, they are called "abusers." Abusers have been known to take doses 10 to 100 times higher than the amount prescribed for medical reasons by a doctor. Some abusers pyramid their doses in 6-12-week cycles. At the beginning of the cycle, the steroid user starts with low doses and slowly increases to higher doses. In the second half of the cycle, they gradually decrease the amount of steroids. Neither of these methods has been proven to work. Steroids can make pimples pop up and hair fall out. They can make guys grow breasts and girls grow beards. Steroids can cause livers to grow tumors and hearts to clog up. They can even send users on violent, angry rampages. In other words, steroids throw a body way out of whack. Steroids do make users bulk up, but the health risks are high. It's true, on steroids biceps bulge; abs ripple; and quads balloon. But that's just on the outside. Steroid users may be very pleased when they flex in the mirror, but they may create problems on the inside. These problems may hurt them the rest of their lives. As a matter of fact steroid use can shorten their lives.

The bottom line is that taking illegal steroids is not smart or healthy. The short term effects are vastly outweighed by the long term results. Athletes or anyone who abuse medications, especially steroids, have a short sighted view of life time goals. Learning how abuse of illegal medications can affect your physical, mental, and emotional health is time well spent. Learn and live.

Until next time. Let me know what you think.