Bodybuilders often turn to physicians for the answers about steroid use. The problem here is the credibility gap created by the medical profession itself on the subject of steroids. Organizations such as the American Council of Sports Medicine formerly decreed steroids ineffective for athletic use. They have since recanted their position in the face of overwhelming evidence to the contrary. But the damage has already been done: many athletes take a dim view of medical expertise concerning steroid usage.
Some doctors take an extreme view on steroid use. Rather than supply objective, truthful information about steroids, they overdramatize the situation with scare tactics. For instance, a noted drug researcher at U.C.L.A. stated not long ago that “anyone who uses steroids for more than a month will be dead before they are 40.” He offered little evidence to back up this sweeping contention.
On the other side of the fence are the steroid proponents. They are often represented by those with a vested interest in profits from steroids, such as black market dealers. This group pooh-poohs the danger of steroids. “Where’s the corpus delicti?” they justifiably ask. If steroids are so risky, then why aren’t gyms across the country strewn with the decaying corpses of steroid-using bodybuilders?
Worst-case scenarios
What’s beyond controversy is steroid contraindications. Some people with existing medical conditions should never use steroids. Conditions for which steroids are a definite no-no include:
1) Cancer of the prostate
2) Cancer of the liver
3) Cardiovascular disease (including prior heart attacks, strokes, or atherosclerosis).
4) Liver disease of any kind, including hepatitis.
It’s risky to use steroids with other pre-existing conditions such as high blood pressure, diabetes, kidney disease, prostate problems and bleeding disorders. Let’s now turn to the evidence against steroids.
Steroids and cardiovascular disease
The chief cause of death in the United States is heart disease. Most heart attacks result from atherosclerosis, in which material composed mainly of hardened cholesterol (plaque) obstructs arteries, and prevents blood flow. When a blood clot forms in a coronary artery narrowed by plaque, the part of the heart nourished by that artery is destroyed, this is a myocardial infarction or heart attack. Whether you live or die depends on the amount of cardiac (heart) tissue damaged. Even if you survive, that damaged area often acts as an irritable area that predisposes the heart to another type of often-fatal heart attack called ventricular fibrillation.
Solid evidence points to excessive cholesterol in the blood as the main risk factor for heart disease. Cholesterol is a waxy, fat-like substance that cannot travel freely in the blood. In order to be transported, it must be attached to a protein. These proteins are made in the liver and are called lipoproteins.
Research suggests that of the several different kinds of lipoproteins, some are beneficial, while others in excess are deadly. The beneficial kind is high-density lipoproteins (HDL-C), the “bad” cholesterol, the kind linked to atherosclerosis, is low-density lipoprotein (LDL).
Women are suspected of having less heart disease than men because they usually have higher HDL levels. This natural protection against heart disease disappears in women who smoke and use birth control pills. It’s also reduced in post-menopausal (older) women.
How do you raise HDL levels? You lower bodyfat, and eat a low-fat diet. Aerobic exercise, and to a lesser extent, weight training also raises HDL levels. HDL levels are lowered by smoking, obesity, and using anabolic steroids.
A recent study1 , found that steroid-using bodybuilders had HDL levels 50 percent lower than a group not taking steroids, the steroid group also had LDL levels 57 percent higher than non-users. Five months after quitting steroids, the bodybuilders’ HDL levels were almost back to normal, but their LDL levels were still 20 percent higher than normal.
The steroid users in this study also showed elevated blood pressure. High blood pressure is a primary risk factor in heart disease.
The famous Framingham heart study found a reduction of 10% of blood HDL level increases the chance of heart disease by 25%. In normal males 22% of total cholesterol is in the form of HDL, in steroid users, HDL is only 7.8% of total cholesterol.
All this evidence would point to a high rate of heart disease in bodybuilders on steroids. So why aren’t they dropping dead of heart attacks?
Most bodybuilders follow very low-fat diets. Analysis of their total blood cholesterol usually shows levels of 150 or less. Medical experts say that at this level of cholesterol, atherosclerosis doesn’t occur. Bodybuilders usually stay on low-sodium diets, thus off-setting most of the sodium-retaining properties of steroids. The high-fruit content of bodybuilders’ diets is rich in potassium, which stimulates sodium excretion, and has a protective effect on arteries—particularly in the brain.
With todays’ tougher competition, bodybuilders can’t afford to bulk-up and get fat in the off-season. They maintain a low level of bodyfat year-round through a diet that emphasizes high complex carbohydrates and low-fats. A lower level of bodyfat usually comes with lower cholesterol levels and reduced blood pressure.
Bodybuilders use aerobics to keep bodyfat levels low. Aerobics also strengthen the heart, and may increase cardiac reserve, which protects against fatal heart attacks.
A major aspect in all this is that most rational bodybuilders never stay on steroids all-year round. They use them for short periods, or cycles, often before major competitions. Those bodybuilders foolish enough to stay on steroids all the time are subject to the possible dangerous effects of steroids on heart disease as mentioned above.
Bodybuilders who don’t follow commonly accepted preventive measures against heart disease are at high risk when they use steroids. This category includes bodybuilders who smoke, eat high-fat diets, gain a lot of bodyfat during the off-season and don’t do any aerobic exercise. These are the people you’ll read about in medical journals.
It’s unknown, however, what future effects steroid use will have for bodybuilders in terms of cardiovascular disease. Present evidence suggests that bodybuilders who get off steroids, and continue to follow favorable preventive measures as outlined earlier, will be at no greater risk than anyone else.
Steroids and cancer
Steroids are cancer promoters for both liver and kidney cancer. Oral steroids are particularly implicated. In the past few years, 14 athletes taking anabolic steroids have had hepatocellular (liver) cancer. All were on oral steroids.
All anabolic steroids are based on testosterone. If you took testosterone by mouth (orally), most of it would be destroyed as soon as it got to the liver, in fact, the stomach acid would destroy most of it before it got into the blood. To offset this, biochemists rearranged the basic testosterone structure to emphasize its anabolic, or buildup properties and prevent destruction in the liver.
It’s the steroid retention in the liver that causes problems, including cancer. Fully 80 percent of athletes using steroids show biochemical abnormalities of the liver. Although all oral, or 17-alkylated steroids are capable of inducing liver cancer, the so-called high androgens, such as Anadrol-50 and Halotestin are particularly potent in this effect.
Even if steroids don’t promote cancer, they can cause a condition called peliosis hepatitis, which are blood-filled cysts in the liver that often predispose to liver failure. So far this particular condition has only been seen in hospital patients on long-term steroid therapy. None of these patients were bodybuilders.
Two bodybuilders are on record as having died from a type of kidney tumor called Wilm’s tumor. This is generally a congenital type of tumor that usually shows up before the age of six. Since both bodybuilders were in their late ’30s when they died, their cases are considered unusual. Some people have linked the deaths of these two men to the use of steroids, but this has never been conclusively shown—although it’s certainly possible.
Steroids and fertility
Recently, on a national television show, a self-proclaimed bodybuilding expert made a fool of himself by saying,”All bodybuilders who use steroids will become infertile, and never be able to sire children.”
The truth is, dozens of famous bodybuilders who’ve used huge quantities of steroids have sired normal, healthy children. But certain forms of steroids, particularly the more androgenic kinds, may induce temporary infertility.
These androgens can be converted to estrogens, or female hormones. The estrogens inhibit the pituitary gland in the brain from releasing substances such as luteinizing hormone and follicle-stimulating hormone that control testicular sperm production. Drugs that don’t convert to estrogen are less potent in this effect.
If steroids are taken for long periods of time, the testicles may atrophy to such an extent that the man may indeed become permanently infertile. Usually ,however, sperm production returns to normal when a bodybuilder stops using steroids.
Steroids and women
Steroid use by women can never be justified. Although women manufacture androgens in their ovaries and adrenal glands, the amount is far less than what men produce. As a consequence, anabolic steroids, which are forms of modified testosterone, masculinize women.
These effects include growth of facial hair, deepening of voice, male pattern baldness, and acne. Except for the acne, these side effects are permanent. This differs from men, in whom most steroid side effects are reversible when usage of steroids stops.
Other possible effects in women include breast shrinkage, clitoral hypertrophy, and a male-type body shape.
Although some people have said steroids may effect women’s fertility on a permanent basis, no definitive evidence of this exists.
Other possible dangers of steroids include negative effects on immune function. Hostile mental states, such as increased aggression and irritability can be increased through steroids.
What ultimately determines steroid side effects are the same for any drug: time and dosage. It all depends on how much of the drug you use, and how long you use it. There is also the possibility of individual sensitivity to these drugs. Some people, because of genetic reasons, may be more sensitive to the side effects of steroids than others. The problem here is you don’t know how sensitive you are until you try them.
The point to remember is that steroids are not harmless substances. They are drugs, and like any drug they can be dangerous if abused. Don’t give yourself a false sense of security by thinking that no one you know seems to be harmed by using steroids. When it comes to long-term effects of steroids, the jury is still out. The risk of steroids is that they can either help you become a champion, or make you a statistic.
Care to find out which category you’re in?
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1 J.W.M Lenders et al. Deleterious effects of anabolic steroids on serum lipids, blood pressure, and liver function in amateur bodybuilders.International Journal of Sports Medicine, Volume 9: 19-23, 1988.
©,2013 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited.
