The
action of testosterone can be in ways both beneficial
and detrimental to the body. On the plus side, this
hormone has a direct impact on the growth of muscle
tissues, the production of red blood cells and overall
well being of the organism. But it may also negatively
effect the production of skin oils, growth of body,
facial and scalp hair, and the level of both "good"
and "bad" cholesterol in the body [among other
things]. In fact, men have a shorter average life span
than women, which is believed to be largely due to the
cardiovascular defects that this hormone may help bring
about. Testosterone will also naturally convert to estrogen
in the male body, a hormone with its own unique set
of effects. As we have discussed earlier, raising the
level of estrogen in men can increase the tendency to
notice water retention, fat accumulation, and will often
cause the development of female tissues in the breast
[gynecomastia]. Clearly we see that most of the "bad"
side effects from steroids are simply those actions
of testosterone that we are not looking for when taking
a steroid. Raising the level of testosterone in the
body will simply enhance both its good and bad properties,
but for the most part we are not having "toxic°
reactions to these drugs. A notable exception to this
is the possibility of liver damage, which is a worry
isolated to the use of c17-alpha alkylated oral steroids.
Unless the athlete is taking anabolic/androgenic steroids
abusively for a very long duration, side effects rarely
amount to little more than a nuisance. One could actually
make a case that periodic steroid use might even be
a healthy practice. Clearly a person physical shape
can relate closely to one overall health and well being.
Provided some common sense is paid to health checkups,
drug choice, dosage and off-time, how can we say for
certain that the user is worse off for doing so? This
position is of course very difficult to publicly justify
with steroid use being so deeply stigmatized. Since
this can be a very lengthy discussion, we will save
the full health, moral and legal arguments for another
time. For now I would like to run down the list of popularly
discussed side effects, and include any current treatment/avoidance
advice where possible.
Acne
Rampant acne is one of the more obvious indicators
of steroid use. As you know, teenage boys generally
endure periods of irritating acne as their testosterone
levels begin to peak, but this generally subsides with
age. But when taking anabolic/androgenic steroids, an
adult will commonly be confronted with this same problem.
This is because the sebaceous glands, which secrete
oils in the skin, are stimulated by androgens. Increasing
the level of such hormones in the skin may therefore
enhance the output of oils, often causing acne to develop
on the back, shoulders, and face. The use of strongly
androgenic steroids in particular can be very troublesome,
in some instances resulting in very unsightly blemishes
all over the skin. To treat acne, the athlete has a
number of options. The most obvious of course is to
be very diligent with washing and topical treatments,
so as to remove much of the dirt and oil before the
pores become clogged. If this proves insufficient, the
prescription acne drug Accutaine might be a good option.
This is a very effective medication that acts on the
sebaceous glands, reducing the level of oil secreted.
The athlete could also take the ancillary drug Proscar®/Propecia®
[finasteride] during steroid treatment, which reduces
the conversion of testosterone into DHT, lowering the
tendency for androgenic side effects with this hormone.
It is of note however that this drug is more effective
at warding off hair loss than acne, as it more specifically
effects DHT conversion in the prostate and hair follicles.
It is also important to note that testosterone is the
only steroid that really converts to dihydrotestosterone,
and only a few others actually convert to more potent
steroids via the 5a-reductase enzyme at all. Many steroids
are also potent androgens in their own right, such as
Anadrol 50® and Dianabol for example. As such they
can exert strong androgenic activity in target tissues
without 5a-reduction to a more potent compound, which
makes Propecia® useless. Of course one can also
simply take those steroids [anabolics] that are less
androgenic. For sensitive individuals attempting to
build mass, nandrolone would therefore be a much better
option than testosterone.
Aggression
Aggressive behaviour
can be one of the scarier sides to steroid use. Men
are typically more aggressive than women because of
testosterone, and likewise the use of steroids [especially
androgens] can increase a person’s aggressive
tendency. In some instances this can be a benefit, helping
the athlete hit the weights more intensely or perform
better in a competition. Many professional power lifters
and bodybuilders take a particular liking to this effect.
But on the other hand there is nothing more unsettling
than a grown man, bloated with muscle mass, who cannot
control his temper. A steroid user who displays an uncontrollable
rage is clearly a danger to him and others. If an athlete
is finding himself getting agitated at minor things
during a steroid cycle, he should certainly find a means
to keep this from getting out of hand. Remembering to
take a couple of deep breaths at such times can Be very
helpful. If such attempts prove to be ineffective, the
offending steroids should be discontinued. The bottom
line is that if you lack the maturity and self control
to keep your anger in check, you should not be using
steroids.
Anaphylactic Shock
Anaphylactic shock
is an allergic reaction to the presence of a foreign
protein in the body. It most commonly occurs when an
individual has an allergy to things like a specific
medication [such as penicillin], insect bites, industrial/household
chemicals, foods [commonly nuts, shellfish, fruits]
and food additives/preservatives [particularly sulfur].
With this sometimes-fatal disorder the smooth muscles
are stimulated to contract, which may restrict a person
breathing. Symptoms include wheezing, swelling, rash
or hives, fever, a notable drop in blood pressure, dizziness,
unconsciousness, convulsions or death. This reaction
is not really seen with hormonal products like anabolic/androgenic
steroids, but this may change with the rampant manufacture
of counterfeit pharmaceuticals. Being that there are
no quality controls for black market producers, toxins
might indeed find their way into some preparations [particularly
injectable compounds]. My only advice would be to make
every attempt to use only legitimately produced drug
products, preferably of First World origin. When anaphylactic
shock occurs, it is most commonly treated with an injection
of epinephrine. Individuals very sensitive to certain
insect bites are familiar with this procedure, many
of who keep an allergy kit [for the self administration
of epinephrine] close at hand.
Birth Defects
Anabolic/androgenic steroids
can have a very pronounced impact on the development
of an unborn fetus. Adrenal Genital Syndrome in particular
is a very disturbing occurrence, in which a female fetus
can develop male-like reproductive organs. Women who
are, or plan to become pregnant soon, should never consider
the use of anabolic steroids. It would also be the best
advice to stay away from these drugs completely for
a number of months prior to attempting the conception
of a child, so as to ensure the mother has a normal
hormonal chemistry. Although anabolic/androgenic steroids
can reduce sperm count and male fertility, they are
not linked to birth defects what taken by someone fathering
a child.
Blood Clotting Changes
The use of anabolic/androgenic
steroids is shown to increase prothrombin time, or the
duration it will take for a blood clot to form. This
basically means that while an individual is taking steroids,
he/she may notice that it takes slightly longer than
usual for a small cut or nosebleed to stop seeping blood.
During the course of a normal day this is hardly cause
for alarm, but it can lead to more serious trouble if
a severe accident occurred, or an unexpected surgery
was needed. Realistically the changes in clotting time
are not extremely dramatic, so athletes are usually
only concerned with this side effect if planning for
a surgery. The clotting changes brought about by anabolic
steroids are amplified with the use of medications like
Aspirin, Tylenol and especially anticoagulants, so your
doctor should be informed of their use [steroids] if
undergoing any notable treatment with these types of
drugs.
Cancer
Although it is a popular
belief that steroids can give you cancer, this is actually
a very rare phenomenon. Since anabolic/androgenic steroids
are synthetic version of a natural hormone that your
body can metabolize quite easily, they usually place
a very low level of stress on the organs. In fact, many
steroidal compounds are safe to administer to individuals
with a diagnosed liver condition, with little adverse
effect. The only real exception to this is with the
use of C17 alpha alkylated compounds, which due to their
chemical alteration are somewhat liver toxic. In a small
number of cases [primarily with Anadrol 50®] this
toxicity has lead to severe liver damage and subsequently
cancer. But we are speaking of a statistically insignificant
number in the face millions of athletes who use steroids.
These cases also tended to be very ill patients, not
athletes, who were using extremely large dosages for
prolonged periods of time. Steroid opponents will sometimes
point out the additional possibility of developing Wilms
Tumor from steroid abuse, which is a very serious form
of kidney cancer. Such cases are so rare however, that
no direct link between anabolic/androgenic steroid use
and this disease has been conclusively established.
Provided the athlete is not overly abusing methylated
oral substances, and is visiting a doctor during heavier
cycles, cancer should not be much of a concern.
Cardiovascular Disease
As mentioned earlier,
the use of anabolic/androgenic steroids may have an
impact on the level of LDL [low density lipoprotein],
HDL [high density lipoprotein] and total cholesterol
values. As you probably know, HDL is considered the
"good" cholesterol since it can act to remove
cholesterol deposits from the arteries. LDL has the
opposite effect, aiding in the buildup of cholesterol
on the artery walls. The general pattern seen with steroid
use is a lowering of HDL concentrations, while total
and LDL cholesterol numbers increase. The ratio of HDL
to LDL values is usually more important than one total
cholesterol count, as these two substances seem to balance
each other in the body. If these changes are exacerbated
by the long-term use of steroidal compounds, it can
clearly be detrimental to the cardiovascular system.
This may be additionally heightened by a rise in blood
pressure, which is common with the use of strongly aromatizable
compounds.
It is also important to note that
due to their structure and form of administration, most
17 alpha alkylated oral steroids have a much stronger
negative impact on these levels compared to injectable
steroids. Using a milder drug like Winstrol® [stanozolol],
in hopes HDL level changes will also be mild, may therefore
not turn out to be the best option. One study comparing
the effect of a weekly injection of 200mg testosterone
enanthate vs. only a 6mg daily oral dose of Winstrol®
makes this very clear. After only six weeks, stanozolol
was shown to reduce HDL and HDL-2 [good] cholesterol
by an average of 33% and 71% respectively. The HDL reduction
[HDL-3 subfraction] with the testosterone group was
only an average of 9%. LDL [bad] cholesterol also rose
29% with stanozolol, while it actually dropped 16% with
the use of testosterone. Those concerned with cholesterol
changes during steroid use may likewise wish to avoid
oral steroids, and opt for the use of injectable compounds
exclusively. We also must note that estrogens generally
have a favorable impact on cholesterol profiles. Estrogen
replacement therapy in postmenopausal women for example
is regularly linked to a rise in HDL cholesterol and
a reduction in LDL values. Likewise the aromatization
of testosterone to estradiol may be beneficial in preventing
a more dramatic change in serum cholesterol due to the
presence of the hormone. A recent study investigated
just this question by comparing the effects of testosterone
alone [280 mg testosterone enanthate weekly], vs. the
same dose combined with an aromatase inhibitor [250mg
testolactone 4 times daily] Methyltestosterone was also
tested in third group, at a dose of 20mg daily. The
results were quite enlightening. The group using only
testosterone enanthate showed no significant decrease
in HDL cholesterol values over the course of the 12
week study. After only four weeks the group using testosterone
plus an aromatase inhibitor displayed a reduction of
25% on average. The methyltestosterone group noted an
HDL reduction of 35% by this point, and also noted an
unfavourable rise in LDL cholesterol. This clearly should
make us think a little more closely about estrogen maintenance
during steroid therapy. Aside from deciding whether
or not it is actually necessary in any given circumstance,
drug choice may also be an important consideration.
For example, the estrogen receptor antagonist Nolvadex®
does not seem to exhibit ant estrogenic effects on cholesterol
values, and in fact often raises HDL levels. Using this
to combat the side effects of estrogen instead of an
aromatase inhibitor such as Arimidex® or Cytadren®
may therefore be a good idea, particularly for those
who are using steroids for longer periods of time. Since
heart disease is one of the top killers worldwide, steroid
using athletes [particularly older individuals] should
not ignore these risks. If nothing else it is a very
good idea to have your blood pressure and cholesterol
values measured during each heavy cycle, being sure
to discontinue the drugs should a problem become evident.
It is also advisable to limit the intake of foods high
in saturated fats and cholesterol, which should help
minimize the impact of steroid treatment. Since blood
pressure and cholesterol levels will usually revert
back to their pre-treated norms soon after steroids
are withdrawn, long-term damage is not a common worry.
Depression
Steroid use will obviously
have an impact on hormone levels in the body, which
in turn may result in a change in ones general disposition
or mood. On the one hand we might see very aggressive
behaviour, but the other extreme of depression also
exists. Depression usually occurs at times when an individual
androgen/estrogen levels are significantly off balance.
This is most common with male bodybuilders, at times
when anabolic/androgenic steroids are discontinued.
During this period estrogen levels may be markedly elevated
[from the aromatization of steroids], which is often
coupled with a deeply suppressed endogenous testosterone
level. Once the steroids are no longer present in the
body, the athlete may suffer with a low androgen level
until the body catches up. Depression may also occur
during the course of a steroid cycle, particularly with
the sole use of anabolics. Although these compounds
are mild in comparison to androgens, many can still
suppress the endogenous Production of testosterone.
If the testosterone level drops significantly during
treatment, the administered anabolics may not provide
enough of an androgen level to compensate, and a marked
loss of motivation and sense of well-being may result.
The best advice when looking to avoid cycle or post-cycle
depression is to closely monitor drug intake and withdrawal.
The use of a small weekly testosterone dose might prove
very effective if added to a mild dieting/anabolic cycle,
warding off feelings of boredom and apathy to training.
And of course a strong steroid cycle should always be
discontinued with the proper use of ancillary drugs
[Nolvadex®, Arimidex®, HCG, Clomid® etc.].
Although tapering schedules are very common, they are
not an effective way to restore endogenous testosterone
levels.
Gynecomastia
Gynecomastia is the medical
term for the development of female breast tissues in
the male body. This occurs when the male is presented
with unusually high level of estrogen, particularly
with the use of strong aromatizing androgens such as
testosterone and Dianabol. The excess estrogen can act
upon receptors in the breast and stimulate the growth
of mammary tissues. If left unchecked this can lead
to an actual obvious and unsightly tissue growth under
the nipple area, in many cases taking on a very feminine
appearance. To fight this side effect during steroid
therapy, many find it necessary the use some form of
estrogen maintenance medication. This includes an estrogen
antagonist such as Clomid® or Nolvadex®, which
blocks estrogen from attaching to and activating receptors
in the breast and other tissues, or an aromatase inhibitor
such as Proviron®, Cytadren® or Arimidex©,
which blocks the enzyme responsible for the conversion
of androgens to estrogens. Arimidex® is currently
the most effective option, but is also the most costly.
It is worth noting however,
that many believe a slightly elevated estrogen level
may help the athlete achieve a more pronounced muscle
mass gain during a cycle [see: Estrogen Aromatization].
With this in mind many athletes decide to use antiestrogens
only when it is necessary to block gynecomastia. It
is of course still a good idea to always keep an antiestrogen
on-hand when administering an aromatizable steroid,
so that it is readily accessible should trouble become
evident. Puffiness or swelling under the nipple is one
of the first signs of pending gynecomastia, which is
often accompanied by pain or soreness in this region
[an effect termed gynecodynea]. This is a clear indicator
that some type of antiestrogen is needed. If the swelling
progresses into small, marble like lumps, action absolutely
must be taken immediately to treat it. Otherwise if
the steroids are continued at this point without ancillary
drug use, the user will likely be stuck with unsightly
tissue growth that can only be removed with a surgical
procedure.
It is also important
to mention that progestins seem to augment the stimulatory
effect of estrogens on mammary tissue growth. There
appears to be a strong synergy between these two hormones
here, such that gynecomastia might even be able to occur
with the help of progestins, without excessive estrogen
levels being necessary. Since many anabolic steroids,
particularly those derived from nandrolone, are known
to have progestational activity, we must not be lulled
into a false sense of security. Even a low estrogen
producer like Deca can potentially cause gyno in certain
cases, again fostering the need to keep anti-estrogens
close at hand if you are very sensitive to this side
effect.
Hair loss
The use of highly androgenic
steroids can negatively impact the growth of scalp hair.
In fact the most common form of male pattern hair loss
is directly linked to the level of androgens in such
tissues, most specifically the stronger DHT metabolite
of testosterone. The technical term for this type of
hair loss is androgenetic alopecia, which refers to
the interplay of both the male androgenic hormones and
a genetic predisposition in bringing about this condition.
Those who suffer from this disorder are shown to posses
finer hair follicles and higher levels of DHT in comparison
to a normal, hairy scalp. But since there is a genetic
factor involved, many individuals will not ever see
signs of this side-effect, even with very heavy steroid
use. Clearly those individuals who are suffering from
[or have a familial predisposition for] this type of
hair loss should be very cautious when using the stronger
drugs like testosterone, Anadrol 50®, Halotestin®
and Dianabol.
In many instances the
renewal of lost hair can be very difficult, so avoiding
this side effect before it occurs is the best advice.
For those who need to worry, the decision should probably
be made to either stick with the milder substances [Deca-Durabolin®
most favoured], or to use the ancillary drug Propecia®/Proscar®
[finasteride] when taking testosterone, methyltestosterone
or Halotestin. Propecia® is a very effective hair
loss medication, which inhibits the 5-alpha reductase
enzyme specifically in the hair follicles and prostate.
This item offers us little benefit with drugs that are
highly androgenic without 5alpha reduction however,
the most notable offenders being Anadrol 50® and
Dianabol. We must also remember also that all anabolic/androgenic
steroids activate the androgen receptor, and can likewise
all promote hair loss given the right dosage and conditions.
Headaches
Athletes sometimes
report an increased frequency of headaches when using
anabolic/androgenic steroids. This seems to be most
common during heavier bulking cycles, when an individual
is utilizing strongly estrogenic compounds. One should
not simply take an aspirin and ignore this problem,
as it is may indicate a more troubling side effect of
steroid use, high blood pressure. Since high blood pressure
invites with it a number of unwanted health risks, monitoring
it on a regular schedule is important during heavy steroid
use, especially if the individual is experiencing headaches.
Some athletes choose to lower their blood pressure in
such cases with a prescription medication like Catapres,
but most find this an appropriate time to discontinue
steroid use. Milder anabolics, which generally display
little or no ability to convert to estrogen, are also
more acceptable options for individuals sensitive to
blood pressure increases. Less seriously, many headaches
are due to simple strain on the neck and scalp muscles.
The athlete may be lifting with much more intensity
during a steroid cycle, and as a result may place added
strain on these muscles. In this case a short break
from training, and general rest, will often take care
of the problem. Of course if anyone is experiencing
a very serious or persistent headache, a visit to the
doctor may be in order.
High Blood Pressure/Hypertension
Athletes using anabolic/androgenic
steroids will commonly notice a rise in blood pressure
during treatment. High blood pressure is most often
associated with the use of steroids that have a high
tendency for estrogen conversion, such as testosterone
and Dianabol. As estrogen builds in the body, the level
of water and salt retention will typically elevate (which
will increase blood pressure). This may be further amplified
by the added stress of intense weight training and rapid
weight gain. Since hypertension [high blood pressure]
can place a great deal of stress on the body, this side
effect should not be ignored. If it is left untreated,
high blood pressure can increase the likelihood for
heart disease, stroke or kidney failure. Warning signs
that one may be suffering from hypertension include
an increased tendency to develop headaches, insomnia
or breathing difficulties. In many instances these symptoms
do not become evident until BP is seriously elevated,
so a lack of these signs is no guarantee that the user
is safe. Obtaining your blood pressure reading is a
very quick and easy procedure [either at a doctors office,
pharmacy or home]; steroid-using athletes should certainly
be monitoring BP values during stronger cycles so as
to avoid potential problems.
If an individual
blood pressure values are becoming notably elevated,
some action should/must be taken to control it. The
most obvious is to avoid the continued use of the offending
steroids, or at least to substitute them with milder,
non-aromatizing compounds. It is also of note that although
aromatizing steroids are typically involved, nonaromatizing
androgens like Halotestin® or trenbolone are occasionally
also been linked to high blood pressure, so these are
perhaps not the ideal alternatives in such a situation.
The athlete also has the option of seeking the benefit
of high blood pressure medications such as diuretics,
which can dramatically lower water and salt retention.
Catapres [clonidine HCL] is also a popular medication
among athletes, because in addition to its blood pressure
lowering properties it has also been documented to raise
the body output of growth hormone.
Immune System Changes
The use of anabolic/androgenic
steroids has been shown to produce changes in the body
that may impact an individual immune system. These changes
however can be both good and bad for the user. During
steroid treatment for instance, many athletes find they
are less susceptible to viral illnesses. New studies
involving the use of compounds like oxandrolone and
Deca-Durabolin® with HIV+ patients seem to back
up this claim, clearly showing that these drugs can
have a beneficial effect on the immune system. Such
therapies are in fact catching on in recent years, and
many doctors are now less reluctant to prescribe these
drugs to their ill patients. But just as a person may
be less apt to notice illness during steroid treatment,
the discontinuance of steroids can produce a rebound
effect in which the immune system is less able to fight
off pathogens. This most likely coincides with the rebound
activity/production of cortisol, a catabolic hormone
in the body, which may act to suppress immune system
functioning. When the administered steroids are withdrawn,
an androgen deficient state is often endured until the
body is able to rebalance hormone production. Since
testosterone and cortisol seem counter each other activity
in many ways, the absence of a normal androgen level
may place cortisol in an unusually active state. During
this period of imbalance, cortisol will not only be
stripping the body of muscle mass, but it may also cause
the athlete to be more susceptible to colds, flu etc.
The proper use of ancillary drugs [antiestrogens, testosterone
stimulating drugs] is the most common suggestion for
helping to avoid this problem, which will hopefully
allow the user to restore a proper balance of hormones
once the steroids are removed.
We also cannot
ignore the other-hand possibility that steroids could
actually increase cortisol levels in the body during
treatment. Termed hypercortisolemia, this effect is
a common occurrence with anabolic/androgenic steroid
therapy. This is because anabolic/androgenic steroids
may interfere with the ability for the body to clear
corticosteroids from circulation, due to the fact that
in their respective pathways of metabolism these hormones
share certain enzymes. When overloaded with androgens
competing for the same enzymes cortisol may be broken
down at a slower rate, and levels of this hormone will
in turn begin build. Due to their strong tendency to
inhibit the activity of the 3beta hydroxysteroid dehydrogenase
enzyme, oral c17 alpha alkylated orals may be particularly
troublesome in regards to elevated cortisol levels,
as again this is a common pathway for corticosteroid
metabolism. Though an elevated cortisol level is not
a common concern during most typical steroid cycles,
problems can certainly become evident when these drugs
are used at very high doses or for prolonged periods
of time. This of course may lead to the athlete becoming
"run-down" and more susceptible to illness,
as well as foster a more over-trained and static [less
anabolic] state of metabolism.
Kidney Stress/Damage
Since your kidneys are
involved in the filtration and removal of byproducts
from the body, the administration of steroidal compounds
[which are largely excreted in the urine] may cause
them some level of strain. Actual kidney damage is most
likely to occur when the steroid user is suffering from
severe high blood pressure, as this state can place
an undue amount of stress on these organs. There is
actually some evidence to suggest that steroid use can
be linked to the onset of Wilms Tumor in adults, which
is a rapidly growing kidney tumor normally seen in children
and infants. Such cases are so rare however, that no
conclusive link has been established. Obviously the
kidneys are vital to ones heath, so the possibility
of any kind of damage [although low] should not be ignored
during heavy steroid treatment. If the user is noticing
a darkening of color [in some cases a distinguishable
amount of blood], or pain/difficulty when urinating,
kidneys strain might be a legitimate concern. Other
warning signs include pain in the lower back [particularly
in the kidney areas], fever and edema [swelling]. If
organ damage is feared, the administered steroidal compounds
should be discontinued immediately, and the doctor paid
a visit to rule out any serious trouble. Since kidney
stress/damage is generally associated with the use of
stronger aromatizing compounds such as testosterone
and Dianabol [which often raise blood pressure], individuals
sensitive to high blood pressure/kidney stress should
such compounds until health concerns are safely avoided.
If steroid use is still necessitated by the individual,
it may be a good idea to avoid the stronger compounds
and opt for one of the milder anabolics. Primobolan®,
Anavar and Winstrol® for example do not convert
to estrogen at all, and likewise may be acceptable options.
Also favorable drugs in this regard are Deca-Durabolin®
and Equipoise, which have only a low tendency to convert
to estrogen.
Liver Stress/Damage
Liver stress/damage
is not a side effect of steroid use in general, but
is specifically associated with the use of c17 alpha
alkylated compounds. As mentioned earlier, these structures
contain chemical alterations that enable them to be
administered orally. In surviving a first pass by the
liver, these compounds place some level of stress on
the organ. in some instances this has led to severe
damage, even fatal liver cancer. The disease peliosis
hepatitis is one worry, which is an often life threatening
condition where the liver develops blood filled cysts.
Liver cancer [hepatic carcinoma] has also been noted
in certain cases. While these very serious complications
have occurred on certain occasions where liver-toxic
compounds were prescribed for extended periods, it is
important to stress however that this is not very common
with steroid using athletes. Most of the documented
cases of liver cancer have in fact been in clinical
situations, particularly with the use of the powerful
oral androgen Anadrol 50® [oxymetholone]. This may
be directly related to the high dosage of this preparation,
as Anadrol 50® contains a whopping 50mg of active
steroid per tablet. This is a considerable jump from
other oral preparations, most of which contain 5mg or
less of a substance. With one Anadrol 50® tablet,
the liver will therefore have to process [roughly] the
equivalent of 10 Dianabol tablets. This obvious stress
is further amplified when we look at the unusually high
dosage schedule for ill patients receiving this medication.
With Anadrol 50®, the manufacturer recommendations
may call for the use of as many as 8 or 10 tablets daily.
This is of course a far greater amount than most athletes
would ever think of consuming, with three or four tablets
per day being considered the upper limit of safety.
It is also important to note that the actual number
of cases involving liver damage have been few, and have
not been a significant enough of a problem to warrant
discontinuing this compound. Methyltestosterone, this
first steroid shown to cause liver trouble, is also
still available as a prescription drug in this country.
The average recreational steroid user who takes toxic
orals at moderate dosages for relatively short periods
is therefore very unlikely to face devastating liver
damage.
Although severe liver damage may
occur before the onset of noticeable symptoms, it is
most common to notice jaundice during the early stages
of such injury. Jaundice is characterized by the buildup
of bilirubin in the body, which in this case will usually
result from the obstruction of bile ducts in the liver.
The individual will typically notice a yellowing of
the skin and eye whites as this colored substance builds
in the body tissues, which is a clear sign to terminate
the use of any c17 alpha alkylated steroids. In most
instances the immediate withdrawal of these compounds
is sufficient to reverse and prevent any further damage.
Of course the athlete should avoid using orals for an
extended period of time, if not indefinitely, should
jaundice occur repeatedly during treatment. It is also
a good idea to visit your physician during oral treatment
in order to monitor liver enzyme values. Since liver
stress will be reflected in your enzyme counts well
before jaundice is noticed, this can remove much of
the worry with oral steroid treatment.
Prostate Enlargement
Prostate cancer is currently
one of the most common forms of cancer in males. Benign
prostate enlargement [a swelling of prostate tissues
often interfering with urine flow] can precede/coincide
this cancer, and is clearly an important medical concern
for men who are aging. Prostate complications are believed
to be primarily dependent on androgenic hormones, particularly
the strong testosterone metabolite DHT in normal situations,
much in the same way estrogen is linked to breast cancer
in women. Although the connection between prostate enlargement/cancer
and steroid use is not fully established, the use of
steroids may theoretically aggravate such conditions
by raising the level of androgens in the body. It is
therefore a good idea for older athletes to limit/avoid
the intake of strong 5-alpha reducible androgens like
testosterone, methyltestosterone and Halotestin, or
otherwise use Proscar® [finasteride], which was
specifically designed to inhibit the 5-alpha reductase
enzyme in scalp and prostate tissues. This may be an
effective preventative measure for older athletes who
insist on using these compounds. Drugs like Dianabol,
Anadrol 50® and Proviron, which do not convert to
DHT yet are still potent androgens, are not effected
by its use however. It is also important to mention
that not only androgens but also estrogens are necessary
for the advancement of this condition. It appears that
the two work synergistically to stimulate benign prostatic
growth, such that one without the other would not be
enough to cause it. It has therefore been suggested
that non-aromatizable compounds may be better options
for older men looking for androgen replacement than
lowering androgenic activity in the prostate. It is
easier to accomplish, and should be accompanied with
less side effects. It would also be very sound advice,
regardless of steroid use, for individuals over 40 to
have a physician check the prostate on somewhat of a
regular basis.
Sexual Dysfunction
The functioning of the
male reproductive system depends greatly on the level
of androgenic hormones in the body. The use of synthetic
male hormones may therefore have a dramatic impact on
an individual sexual wellness. On one extreme we may
see a man libido and erection frequency become extremely
heightened. This is most commonly seen with the use
of strongly androgenic steroids, which seem to have
the most dramatic stimulating impact on this system.
In some instances this can reach the point of becoming
a problem, although more often than not the athlete
is simply much more active and aggressive sexually during
the intake of steroids.
On the other extreme
we may also see a lack of sexual interest, possibly
to the point of impotency. This occurs mainly when androgenic
hormones are at a very low. This will often happen after
a steroid cycle is discontinued, as the endogenous production
of testosterone is commonly suppressed during the cycle.
Removing the androgen [from an outside source] leaves
the body with little natural testosterone until this
imbalance is corrected. The loss of its metabolite DHT
is particularly troubling, as this hormone may have
a strong affect on the reproductive system that may
not be apparent with other less androgenic hormones.
It is therefore a very good idea to use testosterone-stimulating
drugs like HCG and/or Clomid®/Nolvadex® when
coming off of a strong cycle, so as to reduce the impact
of steroid withdrawal. Impotency/sexual apathy may also
occur during the course of a steroid cycle, particularly
when it is based strictly on anabolic compounds. Since
all "anabolics" can suppress the manufacture
of testosterone in the body, the administered drugs
may not be androgenic enough to properly compensate
for the testosterone loss. In such a case the user might
opt to include a small androgen dosage [perhaps a weekly
testosterone injection], or again to reverse/prevent
the androgen suppression with the use of medications
like Clomid® or HCG.
It is also interesting
to note that it is not always simply an androgen vs.
anabolic issue. People will often respond very differently
to an equal dose of the same drug. While one individual
may notice sexual disinterest or impotency, another
may become extremely aggressive. It is therefore difficult
to predict how someone will react to a particular drug
before having used it.
Stunted Growth
Many anabolic/androgenic
steroids have the potential to impact an individual
stature if taken during adolescence. Specifically, steroids
can stunt growth by stimulating the epiphyseal plates
in a person long bones to prematurely fuse. Once these
plates are fused, future liner growth is not possible.
Even if the individual avoids steroid use subsequently,
the damage is irreversible and he/she can be stuck at
the same height forever. Not even the use of growth
hormone can reverse this, as this powerful hormone can
only thicken bones when used during adulthood. Interestingly
enough it is not the steroids themselves, but the buildup
of estrogen that causes the epiphyseal plates to fuse.
Women are shorter than men on average because of this
effect of estrogen, and likewise the use of steroids
that readily convert to estrogen can prematurely suppress/halt
a person growth. In fact, the use of steroids like Anavar,
Winstrol® and Primobolan® [which do not convert
to estrogen] can actually increase ones height if taken
during adolescence, as their anabolic effects will promote
the retention of calcium in the bones. This would also
hold true for non-aromatizing androgens such as trenbolone,
Proviron® and Halotestin®. It is of course still
good common sense to advise adolescents to avoid steroid
use, at least until their bodies are fully mature and
steroid use will have a less dramatic impact.
Testicular Atrophy
The human body always
prefers to remain in a very balanced hormonal state,
a tendency known as homeostasis. When the administration
of androgens from an outside source causes a surplus
of hormone, it will cause the body to stop manufacturing
its own testosterone. Specifically this happens via
a feedback mechanism, where the hypothalamus detects
a high level of sex steroids [including androgens, progestins
and estrogens] and shuts off the release of GnRH [Gonadotropin
Releasing Hormone, formerly referred to as luteinizing
hormone releasing hormone]. This in turn causes the
pituitary to stop releasing luteinizing hormone and
FSH [follicle stimulating hormone], the two hormones
[primarily LH] that stimulate the Leydig cells in the
testes to release testosterone [negative feedback inhibition
has been demonstrated at the pituitary level as well].
Without stimulation by LH and FSH the testes will be
in a state of production limbo, and may shrink from
inactivity. In extreme cases the steroid user can notice
testicles that are unusually and frighteningly small.
This effect is temporary however, and once the drugs
are removed [and hormone levels rebalance] the testicles
should return to their original size. Many regular steroid
users find this side effect quite troubling, and use
ancillary drugs like Clomid®/Nolvadex® or HCG
during a steroid cycle in order to try to maintain testicular
activity [and size] during treatment. The more estrogenic
androgens [testosterone, Anadrol 50® and Dianabol]
are of course most dramatic in this regard, and are
therefore poor choices for individuals who seriously
want to avoid testicle shrinkage. Non-aromatizing anabolics
would be a better option, however be warned that all
steroids should have an impact on the production of
testosterone if taken at an anabolically effective dosage
[yes, even Anavar and Primobolan®].
Water and Salt Retention
Many anabolic/androgenic
steroids can increase the amount of water and sodium
stored in body tissues. In some instances steroid induced
water retention can bring about a very bloated appearance
to the body [hands, arms, face etc.], which will also
reduce the visibility of muscle features [loss of definition].
Athletes often ignore this side effect, particularly
during bulking cycles when the excess water stored in
the muscles, joints and connective tissues will help
to improve an individual overall strength. With the
use of many strong androgens, water retention can account
for much of the initial strength and body weight gain
during steroid treatment, with "water-weight"
sometimes amounting to ten or more pounds. Although
water retention may not be the most unwelcome side effect
during a bulking cycle [greater strength and mass],
it can lead to dangerous problems such as high blood
pressure and kidney damage. The body is clearly under
more strain when dealing with an unusually high level
of water, so athletes should not simply ignore this.
Water retention is most specifically associated with
the presence of estrogen in the body, and is therefore
common with the use of aromatizing compounds [such as
testosterone and Dianabol]. If water retention becomes
an obvious problem during a cycle, the use of an antiestrogen
[Nolvadex®, Proviron®] may help minimize it.
The antiaromatase Arimidex® is in fact the most
effective option, which inhibits the conversion of testosterone
to estrogen. Sometimes the athlete will alternately
option for a diuretic, which can rapidly shed the water
so as to achieve a more comfortable/attractive physique
in a very short time. This is a common practice when
preparing for a competition, as diuretic use allows
the user a great level of control over water stores.
Of course discontinuing the offending compounds, or
substituting them with a milder anabolic would be the
simplest option for recreational steroid users.
Virilization
Since anabolic/androgenic
steroids are synthetic male hormones, they can produce
a number of undesirable changes when introduced into
the female body. This includes the possibility of "virilization",
which refers to the tendency for women to develop masculine
characteristics when taking these drugs. Virilization
symptoms include a deepening or hoarseness of the voice,
changes in skin texture, acne, menstrual irregularities,
increased libido, hair loss [scalp], body/facial/pubic
hair growth and an enlargement of the clitoris. In extreme
cases the female genitalia can become very disfigured,
and may actually take on a penis-like appearance. Women
must clearly be very careful when considering the use
of steroids, especially since most virilization symptoms
are irreversible. The stronger androgenic compounds
should obviously be off-limits, with cautious female
athletes restricting themselves to the use of only mild
anabolics such as Winstrol®, Primobolan®, Anavar
and Durabolin® [the shorter acting nandrolone].
Nandrolone is actually the preferred hormone, as it
displays the lowest level of androgenic to anabolic
activity. Since even these milder anabolics have the
potential to cause problems however, users should additionally
remember to be conservative with drug dosages and duration
of intake. After each cycle of course a notable break
from treatment would be a good idea as well, so that
the body has sufficient time to re-establish a hormonal
balance.
|
