By: Jay Horowitz

Whenever you hear the word "steroid" in the news, it is most often referring to some tearful athlete who tested positive, to some expose, or to the "terrible" side effects. Unfortunately, this is the outlook on steroids by a misinformed public. Aside from the side effects that steroids are accused of causing, there are also moral and ethical problems surrounding their use. In this article I plan on addressing all of these issues. One of the problems with many reported side effects is what is omitted. Steroids are frequently prescribed to patients with AIDS, cancers, severe diseases, and other health problems. This pretty easily takes care of the claim that the death rate of steroid users is much higher than in the general public. This information was left out of all anti-steroid statistics due to a possible negative publicity.

There are two types of side effects that steroids can cause. These are toxic side effects, and hormone-induced side effects. The most commonly noted toxic side-effect is liver damage. Many different liver problems are tied to steroid use. The worst of these are liver cancer, cholastasis, and peliosis hepatis. One of the things that I found to be astounding was that these diseases were found almost exclusively in those who had extensive liver damage or some other internal disease before undergoing long-term steroid therapy. It is also of great importance to note that most of these people were using oral androgenic steroids which were 17-alpha alkylated. Especially the potentially liver-toxic methyltestosterne and oxymetholone were given in the course of therapy without suspension for several years. The reason why oral steroids are thought to cause liver damage is because of an alkyl substitute on the C-1 7 alpha of the steroid molecule. This alkyl substitute makes it much harder on the liver. It can go through the liver many times, thus putting heavy strain on it.

In conclusion, while side effects are extremely rare, one who takes oral steroids should know what he or she is doing. Most athletes will "cycle" their steroids. They will be on for a period of time, then will either stop completely, or will switch to a potentially less toxic steroid.

The second type of side effect is hormone-induced. Some of the most common will be addressed here.

Interruption of the natural production of testosterone: One of the problems with taking steroids is that the tremendous increase in natural testosterone production can be inhibited. This can result in a low sperm count, decrease in libido, and testicular atrophy. The degree of severity is determined by the steroid taken, dosage, and duration of the cycle. While it should be noted that these effects are all reverseable, this can cause you to lose your gains upon the completion of a cycle. When the intake of a steroid is stopped, the body is in a highly catabolic state. Estrogen levels can actually be higher than testosterone levels. To counteract this, many steroid users will take HCG or clomid at the end of their cycle. These drugs will help boost the body's natural testosterone production.

Water and salt retention: Most steroids cause an electrolyte imbalance in the body. This can result in edema, or the swelling of tissues. While this is provides an anabolic environment, it also can result in increased water retention, both in the skin and in the blood. This can give the steroid user a bloated look. Another more serious conseuence can result from this as well. Because there is an increase of water in the blood, the heart must work a lot harder to transport this great amount of fluid throughout the body. This can result in an increase in blood pressure.

Feminization: Almost all steroids aromatize, or change to estrogen. This can result in the growth of breasts, soft muscles, and an increase in fatty deposits. This occurs most often at the end of a cycle, when the estrogen level is extremely high in relation to the testosterone level. The intake of anti-estrogen drugs, such as Nolvadex or Proviron can prove to be helpful in fighting feminization.

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Changes in the skin: Aside from the bloating, steroids can also cause severe acne. Unlike the acne you may have come across during puberty, this acne can cover the back, face, chest, and shoulders. If you have acne already, it will most likely get worse, and if you have blemish-free skin, it is likely to be evoked. Surprisingly, males are affected kess frequently than females. The severity of the acne is relative to the users body composition, the steroid(s) consumed, and the dosage. Steroids are partially transformed into DHT, which the receptors of sebaceous glands have a high attraction to. One may assume that the main cause of the acne is DHT (dihydrotestosterone). On males the acne is usually on the back, chest, and shoulders. Females usually exhibit it on the face and back. Acne isn't such a threat to the body, but the type of acne caused by steroid abuse is a dead giveaway. Treatments for localized acne include benzoyl peroxide and salycilic acid (creams), and for acne covering a larger area, oral antibiotics. Other skin problems encountered are roughening of skin in females, and stretch marks in most.

Psychologic "side effects": In long term use of high dosages of steroids, an overly agressive behavior can occur. The advantage of this is that one can train more intensely, but many people can't cope with it well. They become easily aggrivated, angered, and spurred to violence. There can be a psychological dependance because it is impossible to keep all of the gains you got while on steroids after you stop.

GI symptoms: Gastrointestinal problems which are noted include vomiting, diarhea, and nausea. These can all be avoided by either not taking 17-alpha alkylated steroids, or by taking them with a meal.

Hair loss: As stated before, steroids are partially converted into DHT. Both the sebaceous glands and the receptors of the scalp have high affinities to DHT. Put bluntly, if you have a predisposition to hair loss, taking steroids can increase the rate at which it occurs. Keep in mind that while steroids don't cause hair loss, hair thinning/loss is considered irreversable.

Cardiovascular defects: That steroids can cause cardiovascular defects is supported by the fact that steroids reduce HDL levels and raise LDL levels. HDL works to cleanse the arterial walls of cholesterol and fatty deposits, and LDL does just the opposite. Unfortunately, this effect combines with the normal mass diet of fast foor, high calories, high fat, etc. to put the steroid user into a high risk group. It has been shown that the changed values practically return to their original values within several weeks after steroid termination.

Virilization: Virilization, or masculinization, is one of the greatly feared effects of steroid use. Some of the things that can occur include deepening of the voice, growth of excessive body hair, menstrual cessation, clitoral enlargement, and hair loss. All except for the cessation of the menstrual cycle are permanent.

Stunted growth: While weight lifting does not stunt growth, steroid use definitely does. It is interesting to note that there is often a temporary acceleration of bone growth. With continued ingestion of steroids, one must count on a premature closure of the epiphysial cartilage which leads to a growth stunt and ultimately results in a decrease in the normal predicted height. Further growth is impossible. The only steroid that does not cause this side effect is oxandrolone.

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Cardiac hypertrophy: The enlargement of the heart due to steroids is highly debated topic. It is doubtful that this will ever be resolved due to the fact that the hearts of athletes (not on steroids) are bigger and more efficient to begin with.

In conclusion, what the possible side effects of steroid abuse are is controversial. Keep in mind that I am not an advocate of steroid use, and that I have, without steroids, attained a level of fitness which has provided me the ability to compete. I wrote this article to be informative to those who plan on using steroids. I will be writing one steroid profile per month so as to give the reader a closer look at any steroid they may be considering using.

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