What are steroids?
Steroids have been used in the world of fitness and bodybuilding for their muscle growth enhancing effects for quite some time. The benefits versus the risks debate of doping (steroid use) is an ongoing debate and is likely to remain in this state of limbo for the foreseeable future.
Many people ask, “But if steroids make you gain muscle and improve your athletic ability, then how bad can they be?” However, the list of side effects due to the misuse of steroids for muscle growth is an ongoing one and doctors around the world liken medically unsupervised steroid use to a game of Russian roulette, you may be lucky and not suffer from any of the long-term side effects of the drugs, or you may be unlucky and the effects can even go as far as being life-threatening.
A number of steroid users suggest that the media is warping the idea of steroids and their long-term effects. Some regard the use of the drugs as a way to ‘cheat’ the system as steroids are able to provide noticeable fast results. Others see steroids as a great alternative to natural muscle growth and deem the use of these drugs acceptable, so long as they are used appropriately, in cycles and are not abused (taken in higher doses than recommended).
There are certainly some of you who know of steroids users and have seen the effects of muscle gain and ‘roid rage’ (not to mention the endless list of other negative side effects) in action. Although, many have noted that the reason for steroids being a ‘taboo topic’ is that there is a vast amount of research still needing to be conducted in order for the long-term side effects of the drugs to be further explored.
Bear in mind, this article is not intended to bash the use of steroids and throw the drugs right under the bus full of athletes and gym-goers. But rather, the purpose of this article is to explore the class of drugs further and what they do to the human body. Regardless of where you may find yourself on the spectrum of this heated topic, we urge you to drop the dumbbell, get off the track, or off of social media and take a look at the article to follow as we explore the various positions in the debate on steroids and other performance enhancing drugs for muscle building.
Before we dive into the various kinds of steroids, their uses and effects, it would first be appropriate to explain what exactly steroids are.
The term ‘steroid’ has a number of different meanings. Simply put, steroids, which are often hormones that your body produces naturally, are chemicals. Steroids, or hormones, produced by our bodies aid in the functioning of tissues, organs and cells.
On the other hand, steroids can also refer to forms of medicines that are man-made (synthetic).
The dictionary defines steroids as part of a large class of organic compounds containing a characteristic chemical structure that consists of four rings of connected carbon atoms. This includes alkaloids (naturally occurring chemical compounds such as morphine), hormones and vitamins.
There are two main types of steroids, these are:
- Anabolic (anabolic-androgenic) steroids
Steroids play a crucial role in helping our bodies to carry out their vital processes and functions. Different steroids play different roles in the reproductive system and both the function and structure of membranes.
Some examples of common steroids include:
- Cholesterol - High-density lipoprotein (HDL) cholesterol is the good kind of cholesterol that removes harmful cholesterol from the body which aids in reducing your risk of heart disease.
- Vitamin D
What are the different types of steroids?
It is important that you do not confuse anabolic steroids with corticosteroids. To very simply explain the difference (fret not, we will get into more detail on these later), anabolic steroids that are used by athletes are synthetic (man-made) versions of testosterone used for muscle growth. Testosterone is produced naturally by men and women in varying degrees.
Corticosteroids, on the other hand, aid in suppressing an overactive immune system and reduce inflammation and swelling. For example, cortisone is a synthetic version of cortisol and is used for patients suffering from arthritis to aid in reducing inflammation caused by the condition.
For the purpose of this article, we will be focusing on the performance-enhancing class of steroids, being anabolic and/or androgenic steroids as these are used predominantly in the world of body building and athletics.
But, to give you some context, corticosteroids are briefly described below:
These are a group of steroids that fight off inflammation in the body. Corticosteroids refer to hormones that are able to mimic or replicate the effects of certain hormones that the body produces naturally. Cortisol, produced by your adrenal glands, is one of these hormones that corticosteroids replicate in its effects. Corticosteroids work by suppressing your immune system through blocking certain substances produced that trigger inflammatory responses.
Some conditions which corticosteroids are prescribed to treat include1:
- MS (multiple sclerosis)
- Autoimmune conditions
- Skin conditions and rashes (i.e. eczema)
What are anabolic steroids?
Anabolic steroids, which are also known as anabolic-androgenic steroids (AAS), are synthetic (man-made) versions of the hormone testosterone that is naturally made by the body (the main anabolic steroid produced in the body is testosterone). Testosterone is a sex hormone (androgen) that aids in muscle growth, amongst other things. The hormone is produced by the testicles in men and the ovaries in women. The adrenal glands, situated just above the kidneys, also make a small amount of testosterone.
Anabolic steroids increase strength and muscle mass.
There are two main effects of testosterone on the body:
- Anabolic effects – These effects involve an increase in the amount of tissue in the body through increasing the production of proteins (the promotion of muscle growth).
- Androgenic effects – These effects are responsible for developing male characteristics, including a deeper voice and facial hair.
Your pituitary gland (which is located at the base of your brain), aids in regulating the production of testosterone and the secretion of it. FSH (follicle stimulating hormone) and growth hormone (produced by the pituitary gland) are among some of the hormones that stimulate the function of the ovaries and testes.
Why do women need testosterone?
Women need testosterone (in smaller amounts than men), as a part of their vital mix of hormones that regulate mood, sex drive, energy levels and other bodily functions.
Why are anabolic steroids prescribed?
Androgenic and anabolic steroids are prescribed by doctors as medications to treat patients whose bodies produce abnormally low levels of specific hormones, the main one being testosterone or when the patient suffers from an illness that results in muscle depletion (muscle atrophy), as is seen in cancer and AIDS patients.
In some cases, steroids may also be used for the treatment of delayed puberty or the loss of function of the testes, this may lead to a loss of sex drive, also known as libido.
By law, doctors are not allowed to prescribe steroids simply to enhance someone’s athletic performance.
**My Med Memo - Muscle atrophy refers to the wasting away of muscle. Muscle hypertrophy refers to a growth and increase in size of the muscle.
Are steroids illegal?
Yes. In the majority of countries, if you do not have a medical prescription for the use of steroids to treat a condition, then it is illegal to sell, possess or distribute steroids.
What happens when my muscles grow?
When you exercise through lifting weights, running or whatever your field of fitness may be, you are likely to push yourself so that you run faster or lift heavier if and when you can. This creates tiny tears in your muscle fibres. As a natural response to this trauma, your body will begin a process of repair and overcompensate for the damage through adding larger protein strands to build a muscle fibre that is stronger. This process of restoration is known as protein synthesis and results in muscular hypertrophy (muscle gain). Over time, as your start to exercise and push yourself more, this process of ‘tear down and rebuild’ will be repeated, thus resulting in muscle growth. The microscopic breaking of muscle fibres, or small tears, results in that ‘stiff’ feeling you get after a good workout.
What do hormones have to do with steroids?
What role does testosterone have to play in the process of muscle hypertrophy?
Testosterone, as previously mentioned, is a member of the class of hormones referred to as androgens, these are male sex hormones and are responsible for the development and growth of certain male traits that form during puberty, bear in mind, androgens also play a vital role in the development and growth of females.
In healthy adults, the levels of androgens are related to sex drive and muscle mass, amongst other things. In order for this process of muscle growth to take place, the secret ingredient is testosterone, as this hormone fuels muscle building action. Growth hormone is another element that aids in this process, in actual fact, testosterone increases the levels of the growth hormone that your body will release in response to the muscle tears.
When taking anabolic steroids and following an exercise routine, the body will have higher levels of testosterone and androgen and will, therefore, be able to fuel muscle growth more than the body is naturally capable of doing in a short period of time.
But, how does testosterone work?
Testosterone, being the key player in muscle growth, directly impacts the process of muscle gain through binding to tiny receptors on the surface of your muscle cells. This binding action amplifies the signals of biochemicals found in the muscle tissues, which is what causes protein synthesis to take place. During this process, testosterone will also increase the levels of growth hormone, both of which aid in muscle hypertrophy (muscle growth).
Through boosting the process of protein synthesis in your skeletal muscles, the levels of testosterone in your body will increase the extent and rate at which your muscles will adapt to exercise. Through increasing the release of growth factors, one being growth hormone, the presence of testosterone will also promote the process of muscle hypertrophy in general. All of the aforementioned functions and processes will lead to increased strength, recovery and muscular size.
**My Med Memo – Skeletal muscle is the muscle that makes up most of the muscle in your body as it attaches to bones through groups of collagen fibres, these are known as tendons. Skeletal muscles are normally under your control in muscle growth and shaping).
So, it’s quite simple, if testosterone is the key ingredient in muscle growth (the process of repairing muscle tears), then the more your body contains, the more muscle growth is stimulated. Excess testosterone will affect the various functions of cells and organs in the body. However, as with all hormones in the body, when one of these is thrown out of balance, in this case, testosterone or growth hormone, this can have wide-ranging effects on the body.
Bear in mind, that although testosterone has a significant role to play, it is not the only factor in the process of muscle gain, other factors include:
- Sleep quality
- Training and exercise experience
- Glucose levels in the blood (this includes how well the body creates insulin which allows for the use of glucose for energy in the body)
The roles of testosterone include:
- Growth of the testicles and penis
- Sperm production
- Libido (sex drive)
- Building muscles
What role does oestrogen have to play in anabolic steroids?
In order for you to further understand what testosterone does to the body, we need to explain the role that oestrogen plays in taking steroids. As we know, anabolic steroids are basically forms of hormones. Anabolic steroid users are introducing abnormal amounts of synthetic hormones to their bodies. The body, being an ingenious creation, will recognise this abundance of hormones (testosterone being the most prominent one) and will attempt to balance these levels out through producing natural hormones and will either produce more or another hormone (i.e. oestrogen, which is also an androgen being a sex hormone, that is needed for both men and women), or, in other cases, stopping the natural production of hormones.
In order for the body to balance the excess amount of testosterone present due to anabolic steroid use, it will often make oestrogen as these two hormones have a vital relationship in both men and women which requires balance. Thus, in taking steroids, this balance is upset.
In addition to producing more oestrogen, the body may also suppress its production of testosterone (should the user be taking steroids that are a replica of testosterone and do not facilitate the production of testosterone in the body instead). It is for this reason that a number of anabolic steroid users also take supplements that inhibit the production of oestrogen.
Why do men need oestrogen?
Oestrogen is present in both men and women and is a vital hormone for both sexes. Women use oestrogen, which is secreted by the ovaries, to aid in reproduction (foetus formation and development) as well as other vital female functions and characteristics (breast development, ovulation and menstruation etc.)
Seeing as men lack ovaries, their bodies create oestrogen through a process that involves an enzyme known as aromatase which transforms testosterone into oestrogen. Men, like women in regard to testosterone, need much smaller amounts of oestrogen than their female counterparts.
Men need oestrogen in order to aid in the maturation of sperm. This hormone also aids in maintaining a healthy libido (sex drive). Testosterone is vital for stimulating the production of sperm whereas oestrogen helps the sperm to grow into maturity.
The science behind anabolic steroids
What happens to my body when I take steroids?
Once you have ingested an anabolic steroid (these can be injected or taken in tablet form), the AAS (anabolic-androgenic steroid) will travel through your blood stream and will eventually reach the muscle tissue. From here, your muscle tissue will absorb the steroid through androgen receptors, which are basically the muscle cells receiving docks. Once the steroid has been delivered to your muscle cells, the AAS interacts with your cell’s DNA, this stimulates the process of protein synthesis, which in turn, promotes the growth of the cells.
The body’s reaction to the AAS will depend on the amount and variant of the steroid used. Different results can range from a more toned and lean aesthetic physique to a massive, larger body-building appearance. Athletes will typically experiment with a number of different combinations of steroids in an attempt to achieve their desired results.
Why do athletes use steroids?
When anabolic steroids are used by athletes and other fitness enthusiasts (illegally without a prescription), the goal of these drugs is to increase the body’s natural rate of building muscle and in turn, fat burning capabilities when adhering to a healthy exercise and diet regimen. Thus, when anabolic steroids are used by someone with a healthy body (i.e. not suffering from any sort of chronic illness) their body will use the hormones to increase their weight through muscle gain, improving the individual’s performance and the body’s aesthetic appearance.
Although a number of testing procedures have been put into place in order for the use and abuse of steroids to be deterred amongst Olympic and other professional athletes, new designer steroids are constantly becoming available that are able to escape detection, thus athletes who are willing to be ‘one step ahead’ of their peers through illegal doping are often able to do so.
There is also a group of athletes and people who suffer from a condition known as body or muscle dysmorphia. This causes the individual to have an image of their bodies that is distorted. Typically, men who have muscle dysmorphia believe they are never ‘big enough’ and think they look small or weak when they look in the mirror, regardless of how they realistically look in the eyes of others. On the other hand, women who suffer from this condition may believe that they look flabby or fat, even if they are muscular and lean.
Athletes and body builders do not only use steroids to attain an athletic physique, increased strength and muscle hypotrophy, but some also use steroids when they need a faster recovery time for overused, tired and sore muscles. When you exercise intensely, your body (i.e. your adrenal glands) will release cortisol, cortisol is what corticosteroids attempt to mimic the effects of in their synthetic makeup.
Cortisol is the main stress hormone and that is said to be catabolic, meaning it has the opposite effect to anabolic steroids such as testosterone and growth hormones in the fact that it plays a role in the breakdown of muscle tissue (catabolism). Cortisol aids in helping the body to use glucose (sugar) and fat and turn these into energy, therefore regulating blood sugar levels. Cortisol also aids in regulating blood pressure and metabolism, helps the body respond to stress and reduces inflammation. Cortisol levels are elevated as a result of extreme mental and physical stress (which is what some athletes have to undergo to reach their physical prime). The body recognises severe stress levels as a state of emergency and releases more cortisol than normal.
Cortisol’s three main roles in the body are the following:
- Reducing protein synthesis
- Facilitating the process of converting protein to sugar for energy (glucose)
- Halting tissue growth
These three functions are explained in context below:
The reduction of the process of protein synthesis occurs in order to allow for glycogen synthesis (the process of using sugar for energy) which leads to a decrease in the uptake of amino acids (amino acids make up proteins which are needed for muscle growth). This, in turn, halts tissue growth.
So, when a person has exercised intensely and cortisol has been released as a result, their muscles may not experience the growth and strength needed in order to improve performance. This results in the breakdown of muscle tissue due to increased levels of cortisol in the body is signalling the tissues that they are under an increased amount of stress and should halt any growth in order for the body to recover from the intense training.
When athletes use steroids they often stack these with drugs or use a specific from of steroid that will block the effects of cortisol release in the body which will allow for them to achieve increased muscle gain and performance that may have been unattainable when not using steroids, this is explained further below.
But, I thought that exercise makes you happy not stressed?
In essence, exercise releases endorphins which are released by your pituitary gland and aid in relieving pain and bringing about feelings of euphoria or pleasure. The issue comes in when athletes over train their bodies through intense workouts without taking breaks, therefore physically and emotionally exerting themselves to the extent that their body recognises this state as a stressful situation needing higher levels of cortisol than normal. This can hinder muscle growth and even break down the muscle tissue. Cortisol can also lead to excess abdominal fat.
Athletes then take certain forms of AAS to block the effects of cortisol on their muscles, in turn blocking the hormones from binding to the receptor sites of their muscle cells, diminishing the process of muscle loss. This also allows for faster recovery from training.
Bear in mind, when anabolic steroids block cortisol levels to an extent where the natural functions of cortisol can no longer be performed, this can have a negative impact on the body and can result in a number of issues such as dehydration, extreme fatigue, decreased appetite and irritability, to name a few.
How do athletes take steroids?
Some steroid users cycle their doses of steroids. This refers to taking a number of doses over a specific period of time, stopping for some time and then starting again, therefore, taking breaks in between.
The term ‘stacking’ refers to taking two or in some cases, more, different kinds of anabolic steroids. Other users may use a ‘pyramid’ technique which means they will start on a lower dose and gradually increase this through either frequency or quantity, and then taper off on their dosage in order for a cycle to be completed.
Steroid users believe that the technique of ‘stacking’ will enhance the anabolic effects of the steroids and ‘pyramiding’ will allow for their body to grow accustomed to higher doses of the steroids, with the periods in between that are ‘steroid-free’ helping their bodies to recuperate from the effects of the drugs. However, there is currently no scientific evidence that backs any of these beliefs.
Why do people abuse anabolic steroids?
Steroid abuse applies to cases where the user takes 10 to even 100 times higher doses than those recommended for specific medical conditions.
A number of steroid users believe that they will only use the drugs until they are able to achieve their desired results, however, these results, such as lean muscle gain, can often become addictive and once the user has reached their initial goal, they may want to take it one step further, up their dose, take a different kind of steroid or prolong their current course. This is when the drugs form part of an addiction and when stopped, the user can experience a number of withdrawal symptoms such as fatigue, insomnia, restlessness, mood swings, depression and a loss of appetite.
Always bear in mind that anabolic steroids are powerful hormones and affect the body as a whole.
The effects you experience may be different to someone else’s as everyone’s body is different. Many steroids users note a drastic muscle gain in the first few cycles of using steroids, after which they have to increase their dosage in order to get the same effects. This opens the door for more side effects and further complications as the dosage is increased.
Anabolic steroids are often abused because of the fact that these drugs are able to give athletes the competitive edge they need to be the best, get bigger, look leaner and lift heavier. Compared to the ‘natural’ alternative of eating well and living a healthy life, steroids are able to boost strength and allow for the user to get to their goal a lot quicker without the fatigue, muscle soreness and burnout that is often associated with fitness and exercise. But one must ask the question, “is this short-term gain worth the long-term side effects that may occur?”
What happens to your body when you stop taking steroids?
Earlier we spoke about the cause and effect relationship between testosterone and oestrogen hormone levels in both men and women.
When users stop taking steroids their testosterone levels will be lower, and if their body has inhibited the production of this hormone, their levels of testosterone may be close to non-existent. On top of this, oestrogen levels may be higher than normal as a result of the body attempting to balance the previous excess of testosterone present. Because of this, many steroid users prefer to use steroids in 12 weeks or fewer cycles or periods of time in order for their bodies to adjust more gradually, the effectiveness of this method is not proven and does not guarantee that the side effects of steroids are prevented.
The body will work towards regaining its natural balance of hormones, however, this can take weeks and even months to reach. During this period of time, the user will experience a large amount of muscle loss as a result of the breakdown of muscle tissue due to the loss of the ‘muscle fuel’ testosterone being diminished.
The hormonal imbalance created is a contributing factor to the number of side effects of anabolic steroid abuse.
What types of steroids are there?
Anabolic steroids are available as medications prescribed by doctors for patients suffering from muscle atrophy in cases such as AIDS and cancer. AAS can also be used for patients whose bodies no longer produce enough testosterone naturally and thus their sexual functioning and libido are impaired.
These drugs that include testosterone and growth hormone, are often used illegally without a prescription and are often abused in order to increase one’s athletic performance and appearance.
The platform for debate comes in regarding the positive effects of steroids in athletes as the results are often lean muscle gain and fat loss, therefore performance and general morale are improved. But, and this is a rather important ‘but’, the issue arises when anabolic steroids are used on a healthy person, as opposed to someone who lacks the anabolic hormones, the results, although more than satisfactory, can have some dire consequences as abnormally high levels of testosterone and growth hormone can upset the natural balance of the body.
There are a number of common AAS (anabolic-androgenic steroids) available, some of which are able to directly mimic the effects of natural testosterone, while other will cause the production of excess testosterone in the body through interfering with the natural regulation system of hormones, both kinds of drugs however have the same end result. The excess testosterone will affect every organ and cell function within the body.
Steroids have several chemical names, they also have trade names, or rather, ‘street’ names. One example of this is the chemical hormone known as stanzol which is manufactured and labelled Winstrol, often known as ‘Winny’ for short.
Depending on the type of anabolic steroid, they can either be taken orally through a tablet or pill form or injected. Injected forms of steroids are often higher doses and the effects are often more potent as the drug has direct access to the blood stream.
The different types of steroids explained
Commonly known anabolic steroids
(methandrostenolone, methandienone (INN) or methandienone (BAN))
- Winstrol (Winny for short)
- Deca-Durabolin (deca for short)
- Equipoise (Equi for short)
- Dianabol (Dbol for short)
- Tetrahydrogestrinone (THG)
What are designer steroids?
Steroids that are manufactured to pass drug tests are known as ‘designer’ steroids, some of which include desoxymethyltestosterone and norbolethone. Because of these steroids, drug tests are constantly adapting to try and detect these synthetic drugs.
Other performance enhancing drugs
The below-mentioned drugs are the preferred choice when it comes to fat loss and lean muscle gain. These drugs are popular amongst athletes and are worth the mention in this article as the above classes of steroids are often stacked with them:
Also known as Clen, is a class of bronchodilator, meaning that is assists in the dilation of air passages that lead to the lungs. Clen is used medically for individuals with breathing conditions such as asthma. Athletes and a number of everyday people will use this drug to burn fat and gain lean muscle mass. Clen is not a steroid, but it is a popular drug in the class of performance enhancing supplements and is often used illegally without a prescription.
Clen works through a process known as thermogenesis. This refers to the process of the drug triggering cells in the body to release heat. If your body’s temperature is increased, it means that your metabolism will work quicker, burning more fat and building more muscle as the absorption rate of nutrients is increased.
The process of the thermogenesis requires more energy, this leads to more of the food consumed being used for sustaining this function and in turn, not being stored as fat.
This popular diet drug poses the risk of side effects, as with a number of other diet pills. The issue comes in with the fact that clenbuterol is also absorbed by a number of tissues and organs in the body. This can lead to cell death, when cell death is experienced in the heart it can lead to heart failure. The toxic properties of the drug also play a role in liver failure and other conditions.
People who take clen will also suffer from shaking hands and body tremors, anxiousness and nausea. The thermogenic properties of clen can also result in nervousness, an elevated heart rate, muscle tremors and high blood pressure.
When this drug is used as a prescription drug for certain conditions such as asthma, however, unsupervised and off-label abuse of this drug can lead to severe side effects and dangers. These side effects have been proven to manifest in animals who have been given the drug, however, they are yet to be documented in humans. Doctors warn that using this drug can have long-term effects on the heart as the drug is bound to do damage to the cardiac muscle and cells.
Because the drug was first used to treat horses with lung conditions and breathing disorders, the drug is often easy to get hold of as anyone who owns horses can get a prescription from a vet.
Clenbuterol is a potent drug and bodybuilders and athletes who take it often do so in much higher doses than recommended. Any drug administered in high doses that is able to increase heart rate can have long-term side effects.
This kind of drug is actually a synthetic version of a thyroid hormone that affects your metabolic rate as it has a vital role to play in metabolising a number of substances such as fats, proteins and carbohydrates. T3 is used to treat individuals suffering from hypothyroidism (low thyroid function), meaning that their thyroid is not producing enough of this hormone naturally.
Those who have hypothyroidism have a slower metabolism and will find that their body retains fat more easily and fat loss is often extremely difficult.
Hypothyroidism will be treated through low doses of Cytomel in order to return the metabolism to its normal function.
T3 or Cytomel has become a popular hormone in the world of body building for fat loss and as such, is often abused and taken in higher dosages than required and/or recommended. When T3 is taken by someone with a healthy metabolism, this can upset the natural balance of hormones and result in adverse side effects such as weight gain when the drug is stopped and muscle atrophy if the individual is not eating enough and exercising too extensively for their body and muscles to keep up. With the fat reserves depleted, the body will turn to burning muscle as fuel.
What are the ‘benefits’ of anabolic steroids?
The term ‘benefits’ should be used loosely here as these benefits are often short-lived and a number of severe side effects are often the after effect and consequence of the said benefits.
At this point, we know the facts regarding steroids. These are:
- Steroids are vital chemical compounds that play an important role in our bodily functions. Anabolic hormones are produced naturally in our bodies and are produced in synthetic versions in labs.
- The three primary hormones that are involved in the growth of muscle tissue are:
- GH (growth hormone)
- IGF (insulin-like growth factors) – these are the primary mediators of the effects of GH (growth hormone). Growth hormone that is produced by the pituitary gland, enters the blood stream and stimulates the liver to produce IGF.
- Anabolic steroids influence the body’s metabolism.
**My Med Memo – Your metabolism consists of chemical processes that occur in your body in order for you to function and live. These processes include anabolism, this is the build-up of certain substances and catabolism, this is the breakdown of certain substances. When people use the term ‘metabolism’ they are generally referring to the breakdown of food and the conversion of this into the energy needed to function.
In order to provide insight into both sides of the argument regarding the effects of steroids, it is only appropriate that we discuss the benefits and reasons why a number of people use steroids. Bear in mind, that a number of these perceived benefits are not scientifically proven and are based on some case studies conducted on individuals rather than larger sample groups that would give a more accurate representation of the facts.
There are also several negative side effects as a result of abusive steroid use that will be discussed hereafter.
Some of the benefits of steroid use include:
- Decrease in recovery time – Those who use steroids are known to have their recovery time decrease dramatically. Earlier we spoke about cortisol and the effects that it has on the body, causing damage to the muscle tissues as well as slowing down the time it takes for the human body and muscles to recuperate. Anabolic steroids will often regulate the body’s production of cortisol when the body is under stress. This aids in the recovery time for injuries sustained and muscle trauma being sped up, thus allowing for an increase in stamina when exercising.
- Increase in muscle size – This is one of the most well-known effects of steroids as anabolic steroids facilitate an increase in testosterone levels or when the steroid is a synthetic version of testosterone, will allow for more testosterone to enter the body. Testosterone is a critical factor for muscle growth. In some cases, the muscles will continue to develop without exercise, but exercise and training will reap drastic results.
- Reduction in body fat – Steroids are able to reduce body fat which has been identified as a result of an increased metabolic rate. Some experts also believe that steroids are able to oxidize fat, this is known as lipid oxidation. This refers to using fatty acids for the production of energy.
- Steroids are used to treat several medical conditions – As previously mentioned, steroids were initially used primarily for patients suffering from muscle atrophy as a result of illness or for individuals needing extra testosterone in order to improve their loss of libido or to facilitate puberty when the individual is unable to do so naturally.
- Increase in red blood cell production – Steroids have shown to accelerate the production of red blood cells. Red blood cells are responsible for carrying oxygen throughout the body in order to reach all of the tissues and organs. When more oxygen can be transported to the muscles, this gives them the ability to work harder and for longer periods . Because of this, a number of endurance athletes use anabolic steroids with these effects, despite their use being illegal.
**My Med Memo - EPO (erythropoietin) is a popular steroid due to effect it has on red blood cell count (red blood cells carry and release oxygen and increased numbers of these improve tissue oxygen supply and performance during exercise). In addition to taking this drug, athletes have also started to make use of a process that is referred to as ‘blood doping.’ This is done through removing some of the individual’s own blood and freezing it in a process that is similar to donating blood. The athlete's body will then replenish the red blood cells that have been drawn, then before an event or competition, they will re-inject the blood back into their body. Therefore, creating an increase in their red blood cells and an increase in aerobic performance. However, this process thickens the blood and can lead to blood clots, kidney damage, heart disease or pulmonary embolism (blood clot in the lung). Thus, the side effects can be fatal.
- Increased performance – Steroids are able to enhance the performance as the user experiences more stamina and energy. They can then push themselves hard and reach new limits.
- Increase in appetite – Due to an increased metabolic rate (the rate at which your body turns certain compounds such as sugar, fat and other foods into energy), appetite is increased.
What are the side effects of anabolic steroids?
Before we get into all of the side effects of steroid abuse, it is important that you keep the following in mind:
- Not every person doping (using steroids) will experience all of the side effects
- Some steroid users will experience some of the side effects and not suffer from a number of others
- There may be some steroid users who experience very little side effects, and some who do not experience any, bear in mind, most users will experience at least one of the below side effects
- The severity of the side effects will vary between individuals
- The side effects are dependent on several different factors and depend on the individual’s own body
- For these reasons, these side effects are referred to as potential side effects
General side effects of steroids
The below side effects are the most commonly seen amongst steroid users (we will go into more detail on these below):
- Hair loss
- Oily hair and skin, severe acne all over the body
- Liver disease (cysts and tumours are commonly seen)
- Heart disease (stroke and heart attack)
- Kidney disease
- Mood changes, increased aggression (roid rage), suicidal tendencies, depression and irritability
- Hypertension (high blood pressure)
- High cholesterol
- Gynecomastia (this is the abnormal development of breasts or mammary glands in men, also known as ‘man-boobs’)
- Infertility in men and women
- Testicles shrinking
- Azoospermia (this is semen that does not contain sperm)
- Menstrual irregularities (this is seen in women who use steroids)
- Stunted growth in teens
- Risk of bacterial or viral infection as a result of unsterile injections
- Excess body and facial hair
- Deeper voice in women (and men), this is known as dysphonia
A number of roid users tend to live in denial regarding the side effects of steroids and suggest that those who suffer from the various effects are only steroid abusers and are stacking a number of different forms of the drugs in longer cycles than need be, therefore not giving their natural hormone levels and body time to recuperate. However, these claims are not scientifically backed in any way and the side effects of steroids can affect anyone using the drugs as a healthy individual without prescription for purposes other than a professionally diagnosed and monitored medical condition.
Some of the side effects of anabolic steroid use are reversible and can improve through discontinuing the drugs, other side effects can be permanent and even fatal.
The side effects of steroids are a result of the excess amounts of testosterone administered to achieve muscle growth, aerobic capacity and power which affects almost every organ and system in the body. Any drug that affects or changes the homeostasis (the inner workings and systems of the body) of one’s natural state, will have an impact.
These side effects range from physically evident side effects (i.e. acne and hair loss) and even irreversible and life-threatening (i.e. liver damage and heart attacks). 2
The information below describes the effects of steroids:
Past studies conducted on anabolic steroid users have shown that these drugs may boost blood pressure as a result of them disrupting the function of nitric oxide. This is a substance that is produced in the blood vessel lining and open or dilates the blood vessels. When nitric oxide function is inhibited and the blood vessels are not dilated, the constriction of the vessels and blood flow can lead to an increase in blood pressure, this is known as hypertension.
There have been a number of studies conducted that have identified a pattern of increased levels of testosterone leading to psychological and psychiatric problems. These include feelings of extreme anger and aggression, delusions and even hallucinations. The most commonly seen issue in steroid users is ‘roid rage’.
While roid rage is a documented steroidal side effect, it is often the case that users who are naturally aggressive and short-tempered blame their moods on the drugs.
The rapid increase of muscle growth (in some cases), can result in trauma to the tendons that are responsible for attaching muscle to the bone, this puts the user at risk of tendon rupture.
Bone production and growth issues
Steroids can increase the production of bone in the body, particularly in the face and skull. The teeth are also able to spread out as the mandible and maxillae grow (jaw bones above and beneath the teeth).
An overgrowth of one’s forehead often results in a “Hulk” like look. If younger people such as teenagers who still have some growing to do, use steroids, these drugs are able to prematurely close the bone plates for growth, thus leading to stunted growth.
Any skin issues, such as acne, are often associated with the excess use of steroids, these problems are similar to what an adolescent male goes through during puberty as result of the spike in testosterone experienced.
Acne is a common side effect of steroid use. A particularly severe form of acne is known as acne conglobate which can develop during the use of steroids and even after the drugs have been discontinued. Female skin can also become ‘coarser’ in appearance due to steroid use.
Infections of the skin can occur at the site of the injection as a result of unsanitary techniques being used for steroid injections.
Skin abscesses can also occur at the injections sites, these are able to spread to organs inside of the body.
Another issue arises with the rapid growth of muscles and that is stretch marks.
As a result of the introduction of excess testosterone due to steroid use, the male body will suppress the production of natural testosterone. This often leads to the shrinking of testicles and a decrease in sperm count.
Prostate gland and infertility
Only found in males, the prostate gland is located just beneath the bladder. The main function of the prostate is to maintain the activity of sperm. Some steroids have been seen to enlarge the prostate and because the prostate surrounds the urethra, if this is swollen it can interrupt the flow of urine.
When the prostate is interfered with in any way it can lead to the development of abnormal sperm as well as a decrease in sperm count.
Testes (testicles) and testosterone
When taking steroids, the testes (testicles or balls) will often decrease in their normal functioning as a result of the higher levels of testosterone in the body. When the supplementation of testosterone is stopped, it may take some time for the pituitary gland to send signals to the testicles to inform them to manufacture testosterone once again. When steroids are used long-term or in higher doses, the testes can, in actual fact, stop production of testosterone entirely. This can also result in testicular shrinkage.
Whether testicular shrinkage is permanent or not depends on the potency of the dosage, and the duration for which steroids have been taken.
The use of steroids often results in higher levels of water being retained in the body, this is known as oedema and can lead to puffier cheeks and a rounder face. Water retention can also be seen in the feet and ankles.
The long-term abuse of steroids can damage the user’s eyes and result in cataracts, infections and glaucoma.
Both males and females may experience male pattern baldness from the high levels of testosterone caused by steroid use. Testosterone is converted into DHT (dihydrotestosterone) which affects the hair follicles, causing them to thin and eventually die.
Issues with the use of steroids and the heart are not to be taken lightly. Cardiovascular side effects are a common occurrence amongst long-term and even short-term steroid users. The use of some steroids can result in heart disease leading to heart attack, heart failure and a decrease in the functioning of the heart. Studies have shown that those who use steroids suffer from impaired use of the left ventricle of their hearts. The left ventricle is responsible for pumping the oxygenated blood to all of the organs and tissues in the body.
Some steroids also lead to an increase in levels of bad cholesterol in the body which can accumulate as plaque in the blood vessel walls and can lead to strokes and heart attacks.
It has also been seen that blood pressure can increase through the use of steroids, which can result in blood clots (deep vein thrombosis). A disruption in blood flow can also damage the heart muscle.
Athletes taking higher doses of steroids are also able to suffer from an enlarged heart. Bear in mind, the heart is a muscle in itself and the more testosterone present in the body, the more this muscle can grow (hence why men often have larger hearts than women). The risks of an enlarged heart include heart attack and CAD (coronary artery disease) – this is from blocked arteries in the heart and high blood pressure.
Acid reflux, bloating and ulcers have been linked to the use of steroids as a result of stomach acid production being increased due to the hormonal imbalance caused.
Steroids have also been seen to have a physical effect on the aesthetic appearance of the jawline. High amounts of growth hormone and testosterone create the look of a more defined and square jawline as a result of muscle growth in the jaw and the increase of masculine features.
The kidneys are tasked with the vital role of eliminating any waste material from the blood as well as regulating the levels of water and salt in the body. Your kidneys also regulate blood pressure, therefore, high blood pressure can damage your blood vessels and the filtration system of the kidneys. Issues with the use of steroids and the kidneys often arise through the use of oral steroids (tablet form).
The kidneys have to work even harder to absorb and metabolise the steroids, therefore overworking, which can result in tissue damage and scarring. The damage done to the kidneys amongst long-term steroid users has been noted as being more severe than kidney damage amongst morbidly obese people. Should kidney damage occur, then the steroid user should discontinue the use of the drugs. In this case, they may be able to recover from the damage. Some steroids users have suffered from end-stage kidney failure and have required a dialysis. Others, having previously experienced kidney damage, when starting a cycle of steroids again have experienced a relapse of severe kidney damage and dysfunction.
Steroid users also tend to have high protein diets which are often in excess of the recommended intake. This can lead to kidney stones. Too much protein can boost the levels of uric acid and reduce the level of citrate, this is the chemical that is needed in the urine to prevent kidney stones.
High blood pressure can also have an effect on the kidneys due to damage caused to blood vessels by causing the narrowing and thickening of these. This can lead to a reduced supply of blood to and filtration by the kidneys.
The liver is the largest organ in the body and it vital for filtering harmful toxins found in the blood. As well as this, the liver will store specific nutrients such as minerals and vitamins needed for the body and managing the levels of certain chemicals which include sugar, cholesterol and proteins.
The liver creates a substance known as bile which aids in the process of food digestion. The use of steroids is associated with liver damage that is, in some cases, irreversible.
Steroids taken orally are harder for the liver to breakdown and metabolise which can lead to a decrease in the function of the liver and its ability to clear out any waste products. This is not to say that injected steroids do not have any side effects. Different forms of the drug come with their own impact on the body.
Some forms of counterfeit steroids have had bacteria and viruses detected in them which can also lead to a further decrease in liver function.
There are a number of warning signs that your body will exhibit should you be suffering from severe liver damage. One of these is jaundice (a yellowing of the skin and eyes). If liver damage is detected it is advised that the user stop what is causing it, in this case, steroids and allow for the liver to regenerate itself, as it is the only organ in the body that can self-heal. However, these healing properties of the liver are only viable to a certain point, should there be a large amount of damage and scarring present, the liver may not be able to heal itself.
Testosterone can be converted into oestrogen in the male body through the use of the enzyme known as aromatase that is found in the body tissue, mainly muscle and fat. When a man has extra oestrogen in his system, this can lead to a number of different side effects, such as the build-up of extra fat under the skin, oedema (water retention) and the development of gynecomastia, also known as ‘man boobs’.
In most cases, ‘man boobs’ have to be surgically removed as the levels of testosterone in the steroid user’s body do not return to normal once the steroids are stopped.
To combat these effects, a number of athletes also use oestrogen-suppressing drugs known as aromatase inhibitors. An example of this form of the drug is Arimidex.
In women, the breasts will actually shrink in size as a result of the lack of oestrogen and increased testosterone levels.
Other female side effects
The use of steroids in females can result in a process of female characteristics becoming masculinised. Issues that arise are a loss of breast tissue, body fat and a swollen clitoris, this is known as clitoromegaly. Swelling of the clitoris may be a permanent feature and may never resolve even after steroids have been discontinued. Other masculine features that arise are a deepening of the voice, as well as an increase in the size and development of the body and facial hair.
Females who take steroids may also experience irregularities in their menstrual cycles. These abnormalities can manifest through less or more frequent menstruation and in some cases, menstruation may not take place at all. When the steroids are stopped, this often results in the menstrual cycle returning to normal, however, the recovery can range from a number of weeks to months and will depend on the class of drugs and dosages used, as well as the duration of steroid use. Any abnormalities caused are a result of the upset in the natural hormones in the female body and the offsetting of the production of oestrogen from an abundance of testosterone being present in the body. These changes can have an impact on infertility later in the user’s life, however, these effects are yet to be further explored.
Dysphonia (deeper voice)
A deeper voice is a common side effect of anabolic steroids and is seen to often affect females as a result of excess testosterone leading to the development of male characteristics.
Anabolic steroids have an effect on the larynx and the muscles that are involved in the generation of vocals. The development of a deeper voice in females will typically occur in stages, normally beginning with a hoarser voice which is followed by alterations in the pitch of the voice.
The development rate of these changes will depend on the steroids being used, their severity and dosage.
If dysphonia is detected early on, the effects can be reversed through discontinuing the use of steroids. If not, the results are often permanent.
Increased body and facial hair (Hirsutism)
This is particularly seen in women as they may experience hair growth on their face, chest, hands and other areas of the body. This side effect is also dependent on the type of steroid being used and the dosage. As previously stated, steroids may also result in male pattern baldness in men and women. Therefore, steroids often cause an increase in body hair and a decrease in hair on top of the head.
The verdict on steroids
A number of athletes and bodybuilders will attest to the fact that the level of muscle growth and strength achieved when using steroids is not attainable without them. Therefore, natural muscle growth and fat loss results do not compare to those associated with the use of anabolic drugs.
This issue arises amongst athletes and other competitors in the fitness industry when there is a certain standard to meet. Should one competitor start doping and begins to win all of the races or lifts the heaviest weight and has the best physique in bodybuilding competitions, this becomes the benchmark level to reach, and in turn, beat.
As previously stated, the fitness industry is riddled with athletes taking steroids, and many fitness competitions for bodybuilding for both men and women are not regulated and do not test the athletes for steroid use. The playing field is then open for those wishing to gain a competitive advantage through the use of steroids. The mentality then begins to form amongst said athletes of “short-term gain and long-term reward” when it comes to competing, however, a number of roid users still ignorantly ignore the various long-term side effects of steroids and believe themselves to be immune.
The side effects of steroids are just that, long-term and often only manifest years after the person has taken them.
There have been several cases of professional athletes suffering from heart attacks, liver damage and other conditions later on in their lives, once they have passed their prime. These illnesses have led to their deaths at a younger age than most fit, seemingly healthy people would expect to live to.
Then there’s the matter of not knowing where the steroids are coming from. Any drug that is obtained illegally will not have been prescribed nor monitored by a professional. There have been cases of steroids in circulation that were found to be approved for animal use and not for humans. This creates an uncertainty with regards to ‘what’ you are actually taking. Besides all the known side effects of steroids, more are arising on an ongoing basis as doctors and researchers further explore the detrimental impact that these drugs can have when used illegally.
By taking steroids, we are fighting the natural process of our metabolism and bodily functions, upsetting the balance of hormones and in turn, taking a short cut that denies our body of the natural strength, muscle and growth path that it was genetically designed to take.
We need to get to a point where the fitness industry is regulated for doping more thoroughly and the mindset of getting leaner, stronger, faster and better needs to adapt to a point where we only push ourselves to be the best we can be with regards to our natural genetic makeup. Only then will we be able to compete against fair competitors and not have to suffer from the number of drug induced side effects that are detrimental to the health of our minds and bodies. But, we have to ask, “is this dream achievable in an industry that is led by the unattainable norms of perfection on social media?”
The point of the matter is this, steroids have a number of side effects, some of which are yet to be pinpointed and discovered. It is a huge risk to take for short-term physical gain.
- Medicine Plus. 16 May 2016. Steroids. Available: https://medlineplus.gov/steroids.html [Accessed 31.07.2017]
- National Institute on Drug Abuse. August 2006. Anabolic Steroid Abuse. Available: https://www.drugabuse.gov/publications/research-reports/anabolic-steroid-abuse/what-are-health-consequences-steroid-abuse [Accessed 31.07.2017]