Anabolic Steroids Misuse

Anabolic steroids (AS) are natural or synthetic androgens resembling testosterone in their effects. These are also called as Anabolic androgenic steroids (AAS).

Types:

1. Some AS have medicinal uses only e.g., Nebido
2. Some AS have medicinal as well as performance uses e.g., Anadrol
3. Some AS have no only performance uses e.g., Anadur

Medical Uses:

Anabolic steroids are prescription only drugs (Class C drugs) and these are not commonly used for treatment. The main use of AAS is in the conditions which lead to decrease in muscle mass of the body e.g., cancer or AIDS. The AAS may also be prescribed in case of delayed puberty. Some doctors may prescribe AS in anemia as there is inability to produce sufficient testosterone.

Anabolic Steroid Misuse:

Non medical use of AS is not permitted. Anabolic steroids are illegally used as performance enhancing drugs. There is no control over the quality and quantity of the drug used illegally. The illegal use of AS include doses 10 to 100 times more than normal prescription doses.

To pass the doping test AS are modified to produce Designer Steroids. These are extremely hazardous for health as their use and composition is entirely unregulated.

There is no safety for athletes in the use of AS as they are not prescribed and taken on advice from other athletes or athletic gurus on trial-and-error basis.

Epidemiology:

Anabolic steroids are misused not only for performance enhancing purposes but also for aesthetic purposes. Previously the anabolic steroids were used only by athletes to improve their performances but now the anabolic steroids are also used by general population in order to improve their physical activity and appearance as well. Recent studies have found that 3.3% of the world’s population have used anabolic steroids in their life. Most of the user of anabolic steroids were male (6.4%) and lesser number of females were found to be the users of anabolic steroids (1.6%). The anabolic steroids are most frequently used in Middle Eastern countries. Other regions with high number of users of anabolic steroids are South America followed by Europe, North America, Africa and Asia.

Physiology:

Anabolic steroids increases muscle size and strength but only in the presence of weight training by increasing the number of mononuclei (mature muscle cells) to increase protein synthesis. Athletic training causes catabolic effects of glucocorticoids to generate negative nitrogen balance which the body compensates by increasing the protein utilization. AS have anti catabolic effects. When AS are taken with protein diet, it increases the dietary protein utilization and also increases the protein synthesis. AS compete with glucocorticoids for the binding sites, thus causing the reversal of negative nitrogen balance.

AS bind to androgen receptors on the nucleus of muscle cells. The androgen-receptor complex then moves inside the nucleus and bind to complementary site on DNA. This causes the production of mRNA and respective protein and enzyme synthesis. Effects of AS on androgen receptors depends on muscle type and number of receptors. These effects include up-regulation or down-regulation of androgen receptors, increased protein synthesis and increase in number of mononuclei. Increase in physical activity causes increase in androgen receptors thus providing more binding sites for AS resulting in enlargement of muscle.

Patterns of Use:

Some users may take AS continuously. Others may take AS in different patterns of use as they believe it avoid their adverse effects. The different patterns of use are:

1. Cycling: Taking drugs for a period of time and then stop before starting again.
2. Stacking: Taking more than 1 type of anabolic steroid at a time.
3. Pyramiding: Doing a combination of both cycling and stacking.

Administration:

Anabolic steroids can be :

1. Taken by mouth
2. Injected
3. Applied as gels or creams
4. Implanted as pallets under the skin

Adverse effects:

The adverse effects of AS include acne, fluid retention, infertility, enlarged breasts in men and loss of breasts in women, hypertension and psychological effects such as mood swings.

Incorrect use of steroids can lead to cardiovascular problems, liver or kidney problems, high cholesterol, stroke, tendon rupture and osteoporosis.

In adolescents, the use of AS can lead to permanent stunted growth.

Health risks:

Other health risks arise due to sharing needles and the risk of poisoning due to use of unlicensed products. Sharing needles can cause serious infections such as hepatitis and AIDS. If a person uses AS for a long period of time, he can develop psychiatric problems such as impaired judgement, mania or anger and feelings of invincibility.

Addiction:

Anabolic steroids are addictive in nature and withdrawl symptoms are also observed on the discontinuation of the drugs. So the person would want to continue the drug instead of dealing with withdrawl symptoms. The withdrawl symptoms include depression, anxiety, anorexia, difficulty in concentration and decreased sex drive.

One should immediately seek help from GP if they are addicted to use of AS. Your GP will discuss your addiction with you and help you stop taking anabolic steroids.