Steroids by the definition of dr A.D. Callow from 1936. are “the group of compounds comprising the sterols, bile acids, heart poisons, saponins, and sex hormones“.

Steroids are organic molecules that belong to a group called lipids. What is characteristic for steroids is that all of them have basic skeleton structure called esteroid (estran) – molecules with 4 rings (three six-membered rings and one five-membered ring).

When people talk about steroids, especially in sports and fitness, they usually think of sex hormones, to be even more precise one sex hormone – testosterone. Most of the people don’t know or at least don’t think of cholesterol and vitamin D when they think of steroids, but that is exactly what they are.

Testosterone is only one from 5 major classes of steroids hormones: testosterone, progesterone, and estradiol (sex hormones) and 2 more cortisol/corticosterone and aldosterone (corticosteroids).

TESTOSTERONE – ANABOLIC ANDROGEN STEROID SEX HORMONE

Testosterone is an androgenic-anabolic sex hormone, which means male hormone (Andros is Greek for male) with an anabolic ability (anabolism is part of metabolism that includes building and synthesizing organic molecules which is the opposite of catabolism – degrading or breakdown of the complex molecules). That means that testosterone is predominantly a male hormone (testosterone exists in female bodies also, but in a lower amount and without some of its functions) promoting synthesis and building, like sperm formation and elongation of bones (bones grows together with estrogen) and the most interesting function for sport and fitness – muscle mass growth (protein synthesis).

TESTOSTERONE – FUNCTION

There are a lot of people who would probably say that testosterone has one and only function…to let men grow up while still behaving as children…but that is only one of its many functions.

Testosterone is one of the main male sex hormones and the main function is spermatogenesis (sperm formation), gonadotropin (GnRH) feedback, and embryonic differentiation (creating of the male during embryonic development). Secondary sexual physical characteristics, like facial hair, deep voice and promotion of increase of muscle mass in men are also some of the testosterone functions.

Although testosterone has a role in the secondary sexual physical characteristics, dihydrotestosterone (DHT) is more potent (powerful) and more important for it. However, in the study where production of DHT from testosterone was blocked, there was no difference in muscle growth between the group with a blocker and without and muscle grow was increased with increased level of given testosterone. This means that testosterone is more potent as an anabolic for muscle mass growth.

On the other side, muscle growth will reach the plateau when concentration of testosterone is exceeded, so some researchers believe that continuous muscle growth is not due it’s androgen abilities but rather due to its ability to block effects of glucocortico steroids – hormones that stimulate gluconeogenesis (synthesis of glucose in the body) by breaking down proteins. Here it is important to mention that muscles that are not used, practically, daily, will break down in some amount, if energy for the body is needed, or amino acids for other tissues are needed (when there is not enough protein taken from the food). If testosterone really has this ability to block the breakdown of muscles, then practically all growth (increased muscles mass) will be protected and stay. Without exceeded testosterone, muscles that have increased in mass stimulated by exercises will be broken down, whenever there is not enough energy or proteins ingested from the food.

TESTOSTERONE LEVELS AND PRODUCTION BY BODY

Testosterone production can be controlled on a central (brain) and local (cell and tissue like skeletal muscles) level. Central control is going through hypothalamus (GnRH – gonadotropin releasing hormone)-pituitary (FSH – follicle stimulating hormone and LH -luteinizing hormone)-gonad (testosterone) axis. Some research showed that steroidogenic enzymes exist in skeletal muscles that regulate testosterone production. This production is stimulated by exercises in both genders, although levels of DHT and testosterone in males were much higher than in the females.

WHAT HAPPENS IF EXTRA TESTOSTERONE IS ADDED?

Before we explain what happens when additional testosterone is taken, when levels are in the normal range (testosterone levels in the blood), we have to mention that in most of the countries in the world (if not in all) anabolic steroids are illegal without a doctor’s prescription (not even any doctor but specialist with confirmed diagnosis, for example sterility caused by low production of sperm as a result of low levels of testosterone). The reason why testosterone is illegal to be used without a doctor’s prescription is serious side effects and hormonal imbalance.

Hormones are what controls our body. Imagine if you have the remote control that controls all the traffic lights in New York, and you give it to an 8-year old boy, tell him what it does, and send him off to school…that is pretty much what the misuse of hormones would do to our body.

One of the main side effects of excess testosterone is decreased size of testes and sperm count and at the same time, an increase in prostate size (exocrine gland of the male reproductive system). The excess level of testosterone can lead to infertility. The reason is that extra testosterone will reduce production of GnRH – gonadotropin releasing hormone, and that will cause the decrease in FSL and LH and that will decrease sperm production and size of testes and number of spermatozoids. In the same time, since the prostate is androgen-responsive tissue (same as muscles), it will be enlarged when there is an increase in androgen hormones.

It is important to say that, although we said that muscles are androgen-responsive tissue, they will not grow with only increasing levels of testosterone, but with stimulation like exercises. Muscle hypertrophy is stimulated by stress when muscles are overloaded and ‘’think’’ they will tear. Only in that case, muscles will start the process of growing – hypertrophy, by increasing protein synthesis (a building block for proteins). Here is the main role of testosterone – increasing protein synthesis (and potentially blocking hormones responsible for muscle – protein degradation, mentioned above). As we mentioned before, exercises will stimulate increase of testosterone levels, but after puberty, when muscle mass will be bigger in males than females, after that growth of muscle mass, adding more testosterone without stimulating muscles, will not increase muscle mass – there will be no muscle hypertrophy.

WHY USE STEROIDS?

Anabolic steroids, or predominantly testosterone, are often used, or to be precise, abused in sport. The image that most people would have when anabolic steroids are mentioned is bodybuilding. Bodybuilding is an extreme example of muscle growth. The use of steroids and bodybuilding had the same explosion of popularity in the 20^th century. And it is no secret that professional bodybuilders use them in present day. But the story of steroid abuse goes far beyond bodybuilding, almost every sport has some pages of its history written in words on steroids.

After the evolution of the synthetic production of steroids, during the cold war when the eastern and western block couldn’t wait to fight the opponent without actually shooting them, and couldn’t wait to prove that they come from a better side of the world, the steroids were passed along the gyms as Tic-Tacs. It was done under doctors’ supervision, but not with doctors’ objections. Only later when negative effects became so apparent, the medicine had to stop the worldwide steroid frat party.

But the steroids didn’t vanish. Unlike some other supplements such as human growth hormone, when it comes to steroids, they do increase muscle mass when used in combination with heavy exercising. There is no doubt about that. So the market for them will be ever present.

Whenever the anonymous surveys are done among young athletes, it is always surprising how many of them say they would risk their health and their sports career, if that would give them the ability to be champions.

So steroids became improved, with better production, all for use for medicinal purposes, but a lot of it ends up on the black market.

SYNTHETIC ANDROGENIC ANABOLIC STEROIDS

Testosterone and its derivatives are made synthetically as drugs for many different treatments. Pharmaceutical research of anabolic steroids is not focused a lot on muscle grow in healthy individuals but only in some aging related diseases like sarcopenia – the loss of skeletal muscle mass and strength as a result of aging. Osteoporosis is one of the aging diseases that is also sometimes treated with anabolic steroids. In all of these treatments, serious hormonal imbalance is highly possible, and a reaction of other, not targeted tissues. Some of the side effects of using anabolic steroids can lead to liver conditions like peliosis hepatis – blood-filled cysts replacing healthy liver cells. This condition is often diagnosed late when it is already life threatening to treat if any liver failure is present or intra-abdominal bleeding has started.

Use of androgenic-anabolic steroids also can lead to increased risk of atherosclerosis, as a result of increased LDL – low-density lipoprotein and decreased HDL – high-density lipoprotein.

Usually, injectable steroids were differentiated as long-term and short-term steroids. Mostly used today are water-soluble short-term injectable steroids.

Injections are made to an individual muscle (intramuscular). The injection place of the same muscle is often changed in order to evenly distribute the hormone and avoid partial swelling. The same spot should not be re-visited before 12-14 days.

After the injection, the muscle slowly releases the steroid into the blood stream, and it acts on receptor molecules in muscle fibers, sending the signal for protein synthesis. Of course the main stimulation for growth comes from heavy exercising, but hormone treated muscles get far more hypertrophy than one that is not.

Besides the intramuscular injection, there is subcutaneous injections but since subcutaneous tissue can receive only a small amount of hormone it is not recommended.

Different kinds of Synthetic androgenic-anabolic steroids

There are different derivatives of testosterone and they can be used in a different way, orally, injections in the muscles, but also applied on the skin as gels, creams, and patches.

They also go by any different commercial names like oral; Winstrol, Dianabol, Anadrol, and injectable; Deca, Nandrolone, Depo-Testosterone, Cypionate (usually by active substance) and many others. They have different active substance but they are all derived from testosterone, and as such are used with the same goal in mind.

Depending on the administration of the drug, the adverse effect can be different. Oral, in general, have more adverse effect on health than injections, especially on liver – probably because of the metabolism of steroids. Still, in some patients who were administrated with injections, there were also noticed liver injuries.

The injectable steroids are preferred due to the long-term effects. Oral have stronger effects, but are also more dangerous due to the changes in chemistry in order to survive digestion. But keeping that in mind, if used for a competitive purpose, the long lasting effects can be harder to clean in the case of an anti-doping test. So the combination of injectable-oral steroids is often used in order to continue getting the effects but have more control on cleaning time period.

When using androgenic-anabolic steroids, a more important factor that can harm health is dosage and period of taking them. Higher dosage (10-100 times higher than recommended) and prolonged period of use – characterised as abuse of steroids in athletes, are the most important factors that can damage a user’s health.

The adverse effects can be both physical and mental.

No matter if the steroid is used by injection or orally, both men and women are affected by adverse effects.

Mood disorders, paranoia, liver and kidney failure, baldness, development of breast and prostate cancer in men, facial hair grow, changes in menstrual cycle and male baldness pattern in women, enlarged heart, high blood pressure, stroke, etc.

The body can recognize the high level of testosterone is high enough, and stop producing it. So the testicles start to shrink. The high level of testosterone, even though it makes bones elongate, can signal the body to stop growing.

ARE ALL SUPPLEMENTS BAD?

There is probably no one who, as a teenager, started working out and wanted to become “more serious” in his or her training routine, and at the age of about 16-17 brought home a package of proteins or gainers that didn’t hear their mother or father saying “What are you doing with those steroids?”

Protein supplements are proteins taken from whey (a by-product of cheese production). These proteins are micro-filtered, and sometimes pre-digested for easier and faster absorption in the stomach.

People need proteins on a daily level. Depending on daily physical activity from around 1g per 1kg of body mass to a few grams per 1kg of body mass. The harder the activity the more protein we need. We need protein not only for muscle growth and recovery, but for normal functioning of the body.

And besides the protein, those supplements usually have the vitamins, minerals, carbohydrates, and usually great taste.

So unless someone is allergic to some component, or has some other condition, they are perfectly safe to be consumed by a healthy person. The same goes for amino-acids, which are building blocks of proteins.

Protein shakes, gainers (which are practically protein shakes with high percentage of carbohydrates), and amino acids are some basic supplements for athletes.

There are other supplements as well, that should be taken with a dose precaution, such as creatine, and various fat burners (but there are some supplements sold as fat burners but are originally intended for medicinal use so fat burners should be taken with great care, especially in hot weather), that if followed with instruction and consumed by a healthy person, are safe.

These supplements are very different from testosterone, and other anabolic steroids. These supplements are meant to add value and help us tweak our nutrition, while anabolic hormones impact how the body works.

Anabolic steroids can improve physical abilities a lot, but those abilities come with a price. If you choose to take them, follow the rules of proper use and do not abuse the use steroids.