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How Anabolic Steroids Make You Stronger And How They Destroy You
The quick and dirty route to gaining strength is to take some kind of anabolic steroid. These drugs actually trick the body into building up muscle mass and endurance — but they can also age you far beyond your years.
Anabolic steroids work because they masquerade as one of the body’s basic hormones: testosterone.
Testosterone is, in fact, an anabolic steroid, and “anabolic-androgenic steroids” (the technical term for what most of us know as steroids) are just a synthetic version of this famous chemical. Anabolic refers to growth of muscles, and androgenic refers to male sex characteristics. We’ll call them anabolic steroids here, for accuracy’s sake.
How do anabolic steroids make you stronger?
In general, steroids are chemical compounds that share a common structure. There are many types of steroids; anabolic steroids are only one of several that have roles to play in your body.
When you take anabolic steroids, your body breaks the drug down into molecules that can pass into your cells. There, the steroid molecules bind to structures called androgen receptors. This is where anabolic steroids really take on the role of testosterone, because androgen receptors are shaped very specifically to bind with the body’s natural testosterone. Anabolic steroids, however, can also bind with the receptors.
Once this synthetic steroid is in place, the androgen receptor is activated. Depending on the type of cell the steroids are in, this activation can change how certain genes behave — especially the ones that control the changes that happen during puberty.
Steroids affect your normal metabolism in two basic ways, and together they result in greater muscle mass. Once those androgen receptors are activated, some cells increase their production of proteins, which your body uses to build more cells. This is the phase of your metabolic cycle known as anabolism, where small molecules build up into more complex ones and energy is stored. Anabolism is also when your body builds up muscles — so now you know why they’re called anabolic steroids. During anabolims, the cells in your skeletal muscles, or the powerful muscles attached to your bones, begin to replicate and grow. Soon, you’re building up strength and agility.
But not all activated androgen receptors cause this reaction. Some inhibit hormones called glucocorticoids, another type of steroid. Inhibiting glucocorticoids speeds up the breakdown of complex molecules like proteins into smaller units like energy-giving amino acids. The entire breakdown process is called catabolism, and it’s the other half of your metabolic cycle.
By inihibiting glucocorticoids, anabolic steroids shorten the catabolic phase of metabolism. That means your muscles spend less time recovering between workouts, and you can do more with less rest. You can see how steroids might improve athletic performance.
Do they work?
One study showed that men who used steroids for 10 weeks gained 2 to 5 kilograms of lean body mass — muscle, in other words. They also reported a 5% to 20% increase in strength. Study participants gained more muscle mass in their chest, next, shoulders, and upper arms than in other areas. That’s not because they skipped leg day, but because the muscles in these areas have more androgen receptors in their cells. Not surprisingly, the participants improved more noticeably at bench-pressing than in other kinds of weight-lifting.
Clearly, hormone replacement therapy is the most common use of testosterone. Anabolic-androgenic steroids (AASs) have many other potential clinical uses. Most of these center on the anabolic nature of these drugs and their use in people with cachexia, produced by such disease states as HIV, hepatic and renal failure, chronic obstructive pulmonary disease (COPD), some types of cancer, and burns, as well as during postoperative recovery. In most clinical scenarios, the association of protein-calorie malnutrition increases the morbidity and mortality of the primary disease state. By preventing this loss of LBM, the clinician can hope to prevent many of the adverse effects caused by the disease and, perhaps, by other treatments that have been enacted. In all clinical cases, with the exception of cancer, AASs have shown efficacy in weight gain.
In HIV infection, testosterone replacement and AAS use are generally considered. Commonly used AASs include oxandrolone, nandrolone, and oxymetholone. All 3 agents have been studied for increased LBM and weight gain.
AASs have been studied in COPD-associated cachexia. Stanozolol (12 mg/d), after an initial 250 mg IM testosterone injection, has been shown to produce significant improvement in a patient's weight, body mass index (BMI), and strength compared with controls at 26 weeks. A study of 217 COPD patients randomized to nandrolone plus nutrition and exercise or to nutrition and exercise alone, for a total of 8 weeks showed that the nandrolone group had significant increases in LBM and maximum inspiratory pressure. Studies of oxandrolone (20 mg/d) also showed significant gains in weight and inspiratory parameters in tetraplegic patients.
Hepatic failure is also associated with protein-calorie malnutrition and wasting. In a study of 273 patients with moderate weight loss due to alcoholic hepatitis, oxandrolone (80 mg/d) improved hepatic function and nutrition parameters and increased 6-month survival when compared with controls. Although this was considered a preliminary study, it showed that the use of AASs, including oral agents, can be useful even in some types of liver failure with associated weight loss.
Wound and burn healing have been treated with AASs, including testosterone esters, stanozolol, oxandrolone, and nandrolone. These agents increase collagen synthesis and the activity of dermal fibroblasts and have a positive effect on healing rates in previously nonhealing wounds.
Cancer-associated cachexia and anemia are very common. AASs have been proposed for use in cancer-associated weight loss and in the treatment of the hypogonadal state that often accompanies severe cachexia. AASs have also been used for their erythropoietic effects, usually in leukemia treatment.
AAS use in renal failure, especially in patients on hemodialysis, has been investigated. A double-blind, placebo-controlled study of 29 dialysis patients receiving either nandrolone (100 mg/wk) or placebo for 6 months showed significant gains in LBM and in functional parameters. Studies also indicate that the erythropoietic effect of AASs (nandrolone decanoate) is useful in chronic renal disease and that when an AAS is used in combination with recombinant human erythropoietin, the gains in hematocrit are greater than when either agent is used alone.
These are just a sample of the many disease states that AASs are used to treat. In most cases in which the anabolic properties of AASs are desired, an increased ingestion of protein and calories must accompany their use. Topics not explored in this article include hormone replacement therapy and the general use of androgenic agents as such. Indeed, in cases such as endometriosis and fibrocystic breast disease, androgens are used clinically to negatively affect the hypothalamic-pituitary-gonadal axis and to limit disease symptoms or AASs were first classified as schedule III controlled substances in 1990. Newer legislation was passed in 2004 that included substances that could be converted into testosterone in this controlled group.
The topic of drug abuse of any kind is very complex and often difficult to assess accurately and objectively. The abuse of anabolic-androgenic steroids (AASs) is no different. The complex myriad of neurologic effects of AASs is still being studied. Relating this biopharmacology to the individual abusing AASs is a particularly difficult task because of several factors. For one, many individuals abusing AASs have done so in relative secrecy, and many have been reluctant to engage in valid medical research. The lack of a standard when performing research—because of the vast numbers of agents that are sold worldwide on the black market and their relative potency, or complete lack thereof—is another problem. Many counterfeit products are sold and used, which complicates the study of abuse.
Use and Misuse
Doctors prescribe anabolic steroids to patients with diseases like cancer and AIDS, to help them regain body mass they’ve lost to their illnesses. Anabolic steroids are also prescribed to help treat certain hormone deficiencies. It’s illegal to use anabolic steroids to improve athletic performance, but about 1% of the U.S. population has done it.
Using steroids without a prescription can cause unpleasant side effects that go beyond drug charges and being labelled a cheater. Mostly, they’re linked to the androgenic effects of these drugs, or those effects related to male sex characteristics. Basically, your body thinks it’s going through puberty again. Activating the androgen receptors in your cells increases oil production in your sebaceous glands, which leads to acne.
That said, overuse of anabolic steroids can also age you faster. It can lower sperm count and cause testicular atrophy, better known as shrinkage. Changing hormone levels can also lead to baldness in both men and women.
Then there are the cardiovascular problems. Because of the way they affect heart cells, anabolic steroids can cause chronic high blood pressure, as well as enlargement of the heart. Your cholesterol levels also get thrown out of balance, since your steroid-saturated body is producing more LDL cholesterol and less HDL cholesterol, which is the opposite of what the American Heart Association recommends. The hormonal effects of steroid use also increase your risk of prostate cancer (if you’re male) and can cause kidney and liver damage.
Besides the physical issues, anabolic steroids’ effects on the brain can lead to mood swings, irritability, and depression.
It’s not inherently more dangerous to use steroids without a prescription. The problem is that people who use anabolic steroids to enhance athletic performance often have no medical training, and thus engage in riskier behaviors than people who take them legally. They often take higher doses, for longer periods of time. Many people who take anabolic steroids this way also do reckless things like stacking, which involves combining several types of anabolic steroids in the hope of making them more effective.
Tags: Anabolic steroids are one of those superpowers that comes with a price. Bulking up with these drugs will actually weaken you in the long run.
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