We've all heard of these before, but how or why do they happen? Here is an in-depth look into the steroid side effects, why/how they happen and what you can do when you encounter them.
Steroid Side Effects
The action of testosterone can be both beneficial and detrimental to the body. On the plus side, this hormone had 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 affect the production of skin oils, growth of the body, facial hair and scalp hair, and the level of both "good" and "bad" cholesterol in the body. Raising the level of estrogen in men can increase the tendency to notice water retention, fat accumulation and the development of female tissues in the breast (gyno). Raising the levl 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.
On to the sides..
Acne
Rampant acne is one of the more obvious indicators of steroid use. As you know, teens generally endure periods of irritating acne as their testosterone levels begin to peak, but this generally subsides with age. But when taking AAS, 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 lvel of such hormones in the skin may therefore enhance the output of oils, often cuasing acne to develop on the back, shoulders and face. The use of stronly androgenic steroids in particular can be very troublesome, in some instances resulting in very unsightly blemishes all over the skin. To treat acne, you have a number of options: the most obvious is to be very diligent with washing and topical treatments, so as to remove much of the dirt and oil before the pores become clogged. If this proves insufficient, the prescription acne drug Accutane may be a good option. This is a very effective medication that acts on the sebaceous glands, reducing the level of oil secreted. You could also take the ancillary drug Proscar/Propecia during steroid treatment, which reduces the conversion of test into DHT, lowering the tendency for androgenic side effects with this hormone. It should be of note however that this drug is more effective at warding off hair loss than acne, as it more specifically affects DHT conversion in the prostate and hair follicles.
Aggression
Aggressive behavion 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 aggresive tendencies. In some instances this can be a benefit, helping the athlete hit the weights more intensely or perform better in a competition. Many pro powerlifters 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 and uncontrollable rage is clearly a danger to himself and others. If an athlete is finding himself getting agitated at minor things during a cycle, he should certainly find a means to keep this from getting out of hand. Remembering to take a couple deep breaths at such times can be helpful. 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 had an allergy to things like a specific medication (e.g., penicillin), insect bites, industrial/household chemicals, foods (commonly nuts, shellfish, fruits), and foof additives/preservatives. With this sometimes fatal disorder the smooth muscles are stimulated to contract, which may restrict a person's breathing. Symptoms incluse 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 AAS, 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 injectables).
Blood Clotting Changes
The use of AAS 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 sop 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, changed in clotting time aren't extremely dramatic, so athletes are usually only concerned with this side effect if planning for a surgery. The clotting changes brought about by AAS are amplified with the use of medications like Aspirin, tylenol and especially anticoagulants, so your doc should be informed of their use (steroids) if undergoing any notable treatment with these types of drugs.
Cardiovascular Disease
The use of steroids may have an impact on the level of LDL (low density lipoprotein), HDL (high density lipoprotein), and total cholesterol values. The general pattern 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 mor eimportant than one's total cholesterol count, as these two
substances seem to balance each other in the body. If these unfavorable changes in ratio are exacerbated by the long term use of steroidal compounds, it can logically 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.
Since heart disease is one of the top killers worldwide, steroid-using athletes (particularly older individuals) should not ignore these risks. If nothing else, its a very good idea to have your blood pressure and cholesterol values measured during each cycle, making sure to discontinue the drugs if a problem becomes evident. Its also advisable to limit the intake of foods high in saturated fats and cholesterol while on cycle, which should help minimize (a small bit anyway, as diet is not an effective way of controlling this side effect) the impact of steroid treatment. Since BP and cholesterol levels will usually revert back to their pre-treated norms soon after the gear is withdrawn, long-term damage is not a common worry with short-term use.
Depression
Obviously steroid use will 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 other hand, we might see very aggresive behavior. But for some people there's also at times, the other extreme side, depression. This can occur in individuals who are psychologically sensitive to an imbalance in androgen and estrogen levels. This is most common with male bodybuilders, at times when AAS are discontinued. Given a deeply suppressed endogenous testosterone level, it may take time for one's normal hormonal balance to return. During this period, estrogen levels may be more stable than testosterone, as our bodies can produce it from adrenal hormones. The result may be a protracted window of time in which estrogen seems to be the more dominant sex hormone. For some, this window can be filled with feelings of emotional sensitivity, sadness, and lack of motivation (symptoms of depression).
Depression may also occur during the course of a 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 test 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. Of course a strong steroid cycle should always be discontinued with the proper use of ancillary drugs (Nolvadex, Arimidex, HCG, Clomid, etc). Although tapering shcedules are very common, they are not an effective way to
restore endogenous test levels.
Gynecomastia (gyno)
Gynecomastia is the medical term for the development of female breast tissues in the male body. This occurs when the male is presented with an unusually high level of estrogen, particularly with the use of strong aromatizing androgens such as testosterone and dianabol. The excess estrogen can act upon receptors in the breat 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, many find it necessary to use some form of estrogen maintenance medication. This includes an estrogen antagonist such as Clomid or Nolvadex, which blocks estrogen from attaching to and activating receptors in the breast and other tissues, or an aromatase inhibitor such as Femara or Arimidex, which blocks the enzyme responsible for the conversion of androgens to estrogens. Aromatase inhibitors like this are currently the most effective options, but also the most costly.
Puffiness or swelling under the nipple is one of the first signs of pending gynecomastia, often accompanied by pain or soreness in this region. This is a clear indicator that some type of anti-estrogen is needed. If the swelling progresses into small, marble-like lumps, action absolutely must be taken immediately to treat it. Otherwise, if the steroids are continued at this point without ancillary drug use, the user will likely be stuck with unsightly tissue growth that can only be removed with a surgical procedure.
Hair Loss
The use of higly 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 lvel of androgens in such tissues, most specifically the stronger DHT metabolite of testosterone. The technical term for this type of hair loss is androgenic 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 heavy steroid use. Clearly those individuals who are suffering from (or have a familiar predisposition for) this type of hair loss should be very cautious when using stronger drugs like testosterone, anadrol 50, halotesting and dianabol. In many instances, the renewal of lost hair can be very difficult, so avoiding this side-effect before it occurs is the best advice.
Headaches
Athletes sometimes report an increased frequency of headaches when using AAS. 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 may indicate a more troubling side effect of steroid use: high blood pressure. Since high BP invites 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. Some athletes choose to lower their blood pressure in such cases with a prescription medication like Catapres, but most find this an appropriate time to discontinue steroid use. 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 cycle, and as a result may place added strain on these muscles. In this case, a short break from training and some general rest will often take care of this.
High Blood Pressure/Hypertension
Athletes using AAS 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 affinity for estrogen conversion, such as testosterone and dianabol. As estrogen builds in the body, the level of water and salt retention will tipically elevate and lead to increased BP. This may be further amplified by the added stress of intense weight training and rapid weight gain. Since hypertension (high BP) can place a great deal of stress on the body, this side effect should not be ignored. If it is left untreated, high BP 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; steroid-using athletes should certainly be monitoring BP values during stronger cycles so as to avoid potential problems.
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 urine) may cause them some 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. 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 when urinating, kidney 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.
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. While these very serious complications have occurred on certain occasions where liver-toxic compounds were prescribed for extended periods, it is important to stress that this is not very common with steroid-using athletes.
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.
Sexual Dysfunction
The functioning of the male reproductive system depends greatly on the level of androgenic hormones in the body. Therefore, the use of synthetic male hormones may have a dramatic impact on an individual's sexual wellness. On one extreme, we may see a man's libido and erection frequency become significantly 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 problematic, although more often than not, the athlete is simply much more active and sexually aggresive 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 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. Therefore, it is a very good idea to use testosterone-stimulating drugs like HCG and/or Clomid/Nolvadex 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.
Stunted Growth
Many AAS have the potential to impact an individual's stature if taken during adolescence. Specifically, steroids can stunt growth by stimulating the epiphyseal plates in a person's long bones to prematurely fuse. Once these plates are fused, future linear growth is not possible. Even if the individual avoids steroid use subsequently, the damage is irreversible and he/she can be stuck at the same height forever. Not even the use of growth hormone can reverse this, as this powerful hormone can only thicken bones when used during adulthood. Interestingly enough, its not the steroids themselves, but the buildup of estrogen that causes the epiphyseal plates to fuse. Women are shorter than men on average because of this effect of estrogen, and likewise the use of steroids that readily convert to estrogen can prematurely suppress/halt a person's growth.
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 hormones, 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 and shuts off the release of GnRH. This, in turn, causes the pituitary to stop releasing luteinizing hormone and FSH, the two hormones (primarily LH) that stimulate the Leydig's cells in the testes to releaste testosterone. 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 user can notice testicles that are unusually and frighteningly small. This is temporary, and once the drugs are removed (and hormone levels rebalanced) the testicles should return to their original size.
Water and Salt Retention
Many AAS 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 appearence 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-eight" sometimes amounting to ten or more pounds.
Taken from the book Anabolics 2006 by William Llewellyn
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