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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. 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's physical shape can relate closely to one's
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 we 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. 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 tendencies. 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 himself 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 or 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's 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). Our only advice would
be to make every attempt to use only legitimately produced drug products,
preferably of First World origin.
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 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 Wilm's 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
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's 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.
Depression
Steroid use will obviously have an impact on hormone levels in the body,
which in turn may result in a change in one's 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's 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 . 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. 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 which blocks estrogen from attaching to and
activating receptors in the breast and other tissues, or an aromatase
inhibitor which blocks the enzyme responsible for the conversion of
androgens to estrogens.
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.
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. Milder anabolics, which generally
display little or no ability to convert to estrogen, are 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. 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.
Immune System Changes
The use of anabolic/androgenic steroids has been shown to produce
changes in the body that may impact an individual's 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. When the administered steroids are withdrawn, an
androgen deficient state is often endured until the body is able to
rebalance hormone production. 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.
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 Wilm's 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 one's
health, 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 individuals sensitive to high blood
pressure/kidney stress should such compounds until health concerns are
safely avoided.
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.
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.
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. 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's sexual
wellness. On one extreme we may see a man's 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 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.
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.
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's 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 during a steroid cycle
in order to try to maintain testicular activity (and size) during
treatment.
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's 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. If water retention becomes an obvious problem
during a cycle, the use of an antiestrogen may help minimize it.
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. 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 reestablish a hormonal balance.
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