Steroids Remain A Menace
In the competitive world of sports, the pressure of performance overrules many other considerations. The pressure is often so intense that many sportspersons succumb to use of anabolic steroids (commonly called just ‘steroids’) to better their performance. Athletes on steroids are able to endure more physical stress. Sports persons from various disciplines including bodybuilding, weightlifting, shot put and other track and field events, cycling, baseball, wrestling, mixed martial arts, boxing, football and cricket are known to use them.
Notwithstanding the establishment of the World Anti-Doping Agency in 1999 to control the menace, sportspersons continue to use it. To avoid detection with routine athletes’ urine tests, ‘designer steroids’ have been formulated. In countries which have strict regulations against steroids, there is often a huge black market.
Anabolic Steroids: What are they? What do they do?
Anabolic steroids were first isolated, identified, and synthesized in the 1930s, and are now used therapeutically in medicine to stimulate bone growth and appetite, induce male puberty, and treat chronic wasting conditions, such as chronic kidney disease, cancer and AIDS.
- They are drugs that mimic the effects of testosterone and dihydrotestosterone (male hormones) in the body.
- They increase protein synthesis within cells, resulting in the growth of cellular tissue, especially muscles.
- Anabolic steroids also have androgenic and virilizing properties, including the development and maintenance of masculine characteristics such as the growth of the vocal cords, testicles, and body hair (secondary sexual characteristics).
- The androgenic-anabolic ratio of an AAS is an important factor when determining the clinical application of these compounds. Compounds with a high androgenic to anabolic ratio are the drugs of choice in androgen-replacement therapy (e.g., treating hypogonadism in males), whereas compounds with a reduced androgenic to anabolic ratio are preferred for anemia and osteoporosis, and to reverse protein loss following trauma, surgery, or prolonged immobilization.
- There are four common forms in which anabolic steroids are administered: oral pills, injectable steroids, creams/gels for topical application, and skin patches. Oral administration is the most convenient.
Adverse Effects Of Anabolic Steroids
- Most of these are dose dependent and amongst the commonest is the development or worsening of high blood pressure.
- They increase the cardiovascular risks in the user by increasing the bad cholesterol (LDL) and decreasing the levels of good cholesterol (HDL).
- They alter the structure of the heart and cause enlargement and thickening of the left ventricle, which predisposes a person to develop heart attacks, heart failures and sudden cardiac deaths.
- High doses of oral anabolic steroids can cause liver damage, which at times is fatal.
- Acne and baldness are also often noted in persons using them.
- Use of anabolic steroids in pre- pubertal age group causes premature sexual development and also causes stunted growth in the child.
- These drugs have side effects in both males and females. While in males they may cause gynecomastia (development of breast tissue), loss of libido and infertility along with low sperm counts and reduced testicular volumes, in females it increases body hair, enlarged clitoris, and decreased menstrual cycles.
- When taken during pregnancy they may alter foetal development.
- The psychiatric side effects of steroids are increased aggressive behaviour, violence, mania and less frequently, psychosis.
- Long-term users may get addicted to them and experience withdrawal symptoms when trying to leave them.
- Suicidal tendencies have also been reported in people using these drugs.
Renal Side Effects Of Anabolic Steroids
Anabolic steroids causing kidney problems is not well documented. However anecdotal reports abound in literature stating patients going into acute renal failure, (also called acute kidney injury) particularly in association with liver damage.
It is being gradually recognized that anabolic steroids usage over a long term may damage the kidney permanently and cause chronic kidney damage. As these patients have higher lean body mass due to increased muscle mass, frequently they have higher serum creatinine values (serum creatinine is a marker of renal function). Moreover, these drugs can give rise to hypertension, which if uncontrolled can itself damage the kidney.