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We hear about steroids all the time. But what are steroids? Steroids are hormones, substances produced by glands (or organs) that regulate bodily functions and behavior. It is important to understand that there are several types. Steroid hormones in general include:

  • Corticosteroids, including most synthetic steroid drugs, with natural product classes the glucocorticoids (which regulate many aspects of metabolism and immune function) and the mineralocorticoids (which help maintain blood volume and control renal excretion of electrolytes) and,
  • Anabolic steroids (also known as androgenic steroids), natural and synthetic, interact with androgen receptors to increase muscle and bone synthesis.

What are Steroid Hormones?

In popular use, the term “steroids” often refers to anabolic or anabolic-androgenic steroids (AAS). Anabolic steroids may be synthetic, or human-made, and are variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids [AAS]. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers.

Our focus today is on the anabolic version, or anabolic-androgenic steroids [AAS].  These are used to build muscle mass to enhance athletic performance. (If your 65-year-old grandmother is on “steroids” they are most likely not anabolic but corticosteroids which are frequently used for such conditions as asthma, bad allergy reactions [e.g., poison ivy]) or some auto-immune diseases. The most frequently prescribed anabolic steroid is testosterone.

Are There Legitimate Reasons To Take Steroids?

There are legitimate medical indications for AAS to be prescribed to patients. The most common indication is to prescribe testosterone for patients that are deficient in testosterone, which includes hormone replacement for transgender men.  Testosterone is frequently used off-label in men with sexual dysfunction due to low testosterone associated with aging [Low-T]. [Testosterone is not recommended for low testosterone status due to aging due to potential risk for cardiovascular events and stroke.] AAS are prescription only medications. They are sometimes taken without medical guidance to increase muscle mass and improve athletic performance. AAS are recognized to enhance athletic performance by improving endurance and strength, by reducing post-exertion pain and enhancing recovery time. If used in medication that can be legally prescribed there are steroids not approved by the FDA for medical use including androlone and dromostanolone. These are frequently used by bodybuilders, power athletes, and weightlifters for the desired effect on muscle building and shaping. This style of use can cause serious side effects including addiction.

How Are Steroids Administered?

Anabolic steroids including testosterone can be administered as oral pills, injections, creams or topical gels, and skin patches. While testosterone is an FDA approved medication that can be legally prescribed there are steroids not approved by the FDA for medical use including androlone and dromostanolone. These are frequently used by bodybuilders, power athletes, and weightlifters for the desired effect on muscle building and shaping.

What Are the Common Adverse Effects Of Steroids?

Some of the adverse effects of anabolic steroids include but are not limited to hypertension, coronary disease, abnormal cholesterol and lipid profiles, mouth irritation, hot flashes, tendon rupture, muscle pain, emotional disorders including severe mood swings and aggressiveness, violence, suicidal thoughts, insomnia, skin rashes, and acne.

In some instances, individuals that use anabolic-androgenic steroids [AAS] develop an addiction which refers to the continued desire or craving to use a drug despite knowing about or experiencing serious adverse consequences.

Are Steroids Addictive?

The individual most prone to developing an addiction to anabolic steroid use is the athlete and there is evidence that some people who misuse them go on to develop an addiction. Though not generally considered to be intoxicating drugs, anabolic-androgenic steroids may produce potentially reinforcing psychoactive effects such as increased self-confidence and aggressiveness.

Some of the behavioral, social, and emotional symptoms of note include severe, frequently aggressive mood swings, withdrawal from friends and/or family, paranoid thoughts, excessive desire to workout and depression. There is no scientific evidence to support the concept of “Roid Rage” as a behavioral condition that can develop when people use increasing amounts of steroids over an extended period. As the term indicates, people may display unusual and excessive displays of aggression.

Treatment & Recovery For Steroids

Symptoms from anabolic-androgenic steroids withdrawal include mood swings, serious depression, fatigue and excessive sleeping, cravings for steroids, insomnia, loss of sex drive, and loss of appetite.

The first step to recover from addiction to anabolic-androgenic steroids [AAS] is detoxification off the steroids. Medications to stabilize mood swings in a safe environment (like an inpatient rehab center) is generally recommended although not always necessary. Treatment for anabolic-androgenic steroid addiction includes a safe and support environment with Cognitive Behavioral Therapy [CBT], one on one counseling, lectures and education, referral to self-help groups for ongoing support and physician managed medications to treat the psychiatric symptoms frequently seen. Athletes or competitors who abuse steroids may have to make lifestyle adjustments in order to maintain recovery. But as with other addictions, the first step with anabolic steroid addiction is to have the courage to reach out for help.


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