Much has been written about anabolic steroids and frankly – most of it has been written by people who know very little about those substances.
They are either recycled anti-narcotic crusaders who don’t really understand the huge difference between narcotics and anabolic steroids or steroid users themselves.
The later group tends to (quite obviously) underestimate the dangers connected with steroids use and abuse.
Most of serious research in the field of anabolic androgenic steroids (AAS), which are in fact derivatives of testosterone, has been done in 1960’s and 1970’s. Since then, and especially after 1990 (when the US enacted anti-steroid laws) this topic has been avoided like pest in most scientific circles.
We must therefore rely on a mixture of scientific studies, personal experience of older bodybuilders and observation of experienced coaches.
Various steroids cause different side effects
AAS are a group of substances. As such they do not cause the same effects and side-effects. The following list shows some common steroids and their most typical side effects, ordered from most dangerous to mildest ones.
Oxymetholone, Fluoxymesterone – extremely liver toxic
Nandrolone – very severe testosterone inhibition, blood vessel damage
Danabol, Stanozolol (oral) – liver toxic, testosterone inhibition
Testosterone enanthate/propionate, trenbolone – testosterone inhibition
Boldenone, methenolone – mild testosterone inhibition
Oxandrolone – very mild testosterone inhibition
Please notice that “mild” is very relative term here: steroids like boldenone can still cause severe reaction in some persons. Also, it must be stressed that most steroids can cause a whole range of other symptoms, notably gynecomastia (female breast in men caused by direct or indirect activation of estrogenic receptors), acne, hair loss, mood swings and palpitations.
Testosterone inhibition, or in other words lowered testosterone production, will sooner or later affect every steroid user.
Some people may find other AAS side effects tolerable: you may be less sensitive to androgenic side-effects like acne or hair loss, you may avoid oral pills and thus protect your liver and you may also stay clear of anabolic steroids which aromatize or directly stimulate estrogenic receptors (which will cause gynecomastia and other problems).
But your body will always respond to additional testosterone (or its derivatives) by lowering own testosterone production.
This is caused by a mechanism called negative feedback inhibition: the production every hormone whose release is regulated by hypothalamus (and this includes testosterone) is inhibited if the body spots high levels of that hormone (or a similar substance) in the system.
So if you inject, say, testosterone enanthate in the muscle, you also give information to hypothalamus that there is too much testosterone in the system and it should stop producing it.
Unfortunately, the hypothalamus sees every anabolic steroid as testosterone but the negative feedback is stronger with some steroids (like nandrolone) than with others (e.g. oxandrolone).
Testosterone inhibition leads to shrinking of testicles, loss of libido, erectile dysfunction, mood swings and other symptoms associated with low testosterone.
The inhibition can be either reversible or – if the steroid was too strong and used for too long – irreversible. Irreversible testosterone inhibition means that the body is not able to produce testosterone for the rest of your life. Although I never heard of anyone who would end up like this when using steroids, I did meet people with lower-than-normal testosterone production resulting apparently from AAS abuse.
There are two ways how to fight testosterone inhibition: using steroids in cycles and using post-cycle therapy.
The whole concept of cycles simply means that you stop the “therapy” after several weeks and then continue after your testosterone production returns to normal. As a rule, bodybuilders are not undergoing any medical test showing that their testosterone production is really 100% of the previous levels. They are simply following some plan (like 10 weeks cycle and 2 months a break) or rely on their subjective feelings. We can therefore never rule out the possibility that our natural testosterone production is slowly declining.
The “post cycle therapy” (also PCT) is based on using certain drugs with hormonal effects that (by means that we explain in another article). Drugs like clomifen, tamoxifen or anastrozole (also known under their commercial names of Clomid, Nolvadex and Arimidex) are lowering estrogenic hormones (female steroid hormones) and help increase testosterone production by another form of negative feedback.
It should be stressed that applying PCT is another interference with our hormonal system and as such can cause more harm than good. Everyone planning to use AAS should be aware of this fact.
Anabolic steroids sold as pills are usually chemically altered in such a way that the active substance will pass through the liver without being broken down and degraded.
This chemical alteration is called 17-alpha alkylation. 17-alpha alkylated steroids are always liver-toxic and this toxicity is dose-dependent.
In fact, there are many other common drugs causing dose-dependent liver toxicity: pain-killers, NSAIDs, statins, birth-control pills and many others. The problem with AAS is that they are used in much higher doses than what they have been created for.
The most common sign of liver problems are elevated liver enzymes. If you can’t help it and insist on (oral) steroid use, you should have your liver tested twice a year. Elevated enzymes are not always sign of disease – they are more of a warning that something is going on in this important organ and liver inflammation or even necrosis is a real possibility.
Under normal circumstances, part of testosterone in our body is always converted into estradiol, the main female steroid hormone. This process is called aromatization and the enzyme responsible for it is known as aromataze.
Not only testosterone aromatizes to estradiol - many other anabolic steroids also do. This poses a serious problem for AAS users, because in order to be of any help in muscle growth, testosterone (and other steroids) must be applied in very high (or supraphysiological) doses.
As a result, bodybuilders often have supraphysiological (much higher than normal) levels of estradiol causing specific side effects like gynecomastia (growth of female breast in men), water retention and fat accumulation, not to speak of various psychological effects.
Some anabolic steroids (think of trenbolone) do not aromatize but can directly stimulate the estrogenic receptors, thus causing the same side effects as aromatizing steroids.
You may ask: “but why would anyone use the aromatizing steroids in the first place, especially if there are some non-aromatizing substances available?”
The answer is that anabolic steroids that elevate estrogens actually bring much higher muscle mass gains. This is caused by water retention and partly also by fat accumulation. So although the lean muscle actually doesn’t grow more, the visual effect can be very impressive.
The unwanted estrogenic side effects are usually treated by anti-estrogenic drugs. As I said earlier in this article, use of such medicines is another intrusion in the HPTA hormonal axis and it can cause various other side effects.
Cardiovascular disease (disease of heart and/or blood vessels) is often cited as common AAS side effect. There is, however, no direct evidence for such claims. What we do know is the negative impact of at least some anabolic steroids on HDL. HDL (High Density Lipoprotein) is the “good” cholesterol and steroids seem to lower its levels in the system, thus negatively influencing the whole lipid picture.
We also know (although research in this field is limited and thus inconclusive as yet) that Nandrolone, a very popular anabolic steroid, probably damages the endothelial cells of blood vessels.
Anabolic steroids can also cause high blood pressure at least in some users. This is something that we know from experience. High blood pressure is strongly associated with heart disease.
R.I. Wood is author of several scientific studies claiming that testosterone derivatives have opiate-like properties, in other words, that these are addictive substances.
This is obviously a very strong claim that contradicts the common knowledge about testosterone and related hormones. If true, it would give some credit to legislation listing AAS in the same group of substances as narcotics.
Before judging anabolic steroids too harshly, we should realize that number of commonly used substances, and even some of the most common foods, contain opiate-like elements.
Wheat, for instance, contains gluten exorphins.
Milk contains casomorphin peptides. Both are opioid substances enforcing addiction. Many similar peptides are to be found in other common foods.
Coffee, tea and chocolate are even very addictive, probably much more than testosterone.