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) – molecule 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 as 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 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 opposite of catabolism – degradation or breakdown the complex molecules). That means that testosterone is predominantly male hormone (testosterone exists in female bodies also, but in the lower amount and without some of its functions) promoting synthesizes 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 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 man are also one 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 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 continuously muscle grow is not due it’s androgen abilities but rather due to ability to block effect of glucocorticosteroids – hormone that stimulate gluconeogenesis (synthesis of glucose in the body) by breaking down proteins. Here 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 tissue are needed (when there is not enough protein taken from the food). If testosterone really has this ability to block break down of muscles, then practically all grow (increased muscles mass) will be protected and stay. Without exceeded testosterone, muscles that increased mass stimulated by exercises will be broken down, whenever there is no enough energy or proteins ingested from the food.

Testosterone levels and production by body

Testosterone production can be controlled on 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 in skeletal muscles exist steroidogenic enzymes that regulate testosterone production. This production is stimulated by exercises in both genders, although levels of DHT and testosterone in male were much higher than in the female.

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 the most countries in the world (if not in all) anabolic steroids are illegal without a doctor 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 doctor prescription is serious side effects and hormonal misbalance.

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 8-year old child, tell it what it does, and send him off to school…that is pretty much what 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 in the same time incensement of prostate size (exocrine gland of the male reproductive system). The practically 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 like muscles), it will be enlarged (grow) when there is incensement of androgen hormone.

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 only 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 incensement of testosterone levels, but after puberty, when muscle mass will be bigger in male than female, after that grow of muscles mass, adding more testosterone without stimulating muscles, will not increase muscles mass – there will be no muscle hypertrophy.

Why use steroids?

The anabolic steroids, or predominantly testosterone is often used or to be precise abused in sport. The image that most people would have when anabolic steroids are mentioned is bodybuilding. The body building is 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 body builders use them. Present time. But the story of steroids abuse goes far beyond the body building, almost every sport has some pages of its history written in words on steroids.

After the evolution of 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 better side of the world the steroids were passed along the gyms as Tic-Tac. 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 the 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 survey was done among young athletes, it is always surprising how many of them say they would risk the health, the sport career, if that would give them the ability to be champions.

So the steroid became improved, with better production, all that for use them in medicinal purposes, but a lot of it ends up in black market.

Synthetic androgenic anabolic steroids

Testosterone and its derivate are made synthetically pharmaceutically as drugs for many different treatments. Pharmaceutical research of anabolic steroid 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 these treatments, serious hormonal misbalance is highly possible, and a reaction of other, not targeted tissues. Some of the side effects 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 liver failure present or intra-abdominal bleeding start.

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

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

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

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

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

Different kinds of Synthetic androgenic anabolic steroids

There are the different derivate 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 ones Winstrol, Dianabol, Anadrol, and injectable Deca, Nandrolone, Depo-Testosterone, Cyopinate (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 metabolism of steroids. Still, in some patients who were administrated with injections, there were also noticed liver lesions.

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 having that on mind, if used in competitive purpose, the long lasting effects can be harder to clean in a case of 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 more important factor that can impaired health is dosage and period of taking them. Higher dosage (10-100 times higher than recommended) and prolonged period of use – characteristic in abuse of steroids in athletes, are the most important factors that can impaired health.

The adverse effects can be both physical and mental.

No matter if the steroid is used as injected or oral, 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.

Body can recognize the high level of testosterone as high enough, and stop producing it. So the testicles starts 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, or wanted to became “more serious” in his or her training routine, and at the age of about 16-17 brought home the package of proteins or gainers that didn’t hear mother or father saying ”What are you doing with those steroids?”

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

People need proteins on daily level. Depending on daily physical activity from around 1g per 1kg of body mass to 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 beside the protein those supplements usually have the vitamins, minerals, carbohydrates, and usually great taste.

So unless someone is allergic to some component, or have 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 proteins shake 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 instruction and consumed by healthy person are safe.

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

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