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swordfish151
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Ok for all you noobs and for all the spring breakers logging on, this is for you. Im tired of seeing some really "interesting" questions being posted. So I took the liberty to get you folks some information. But first, please dont logg on and ask a question about starting a cycle of a SUBSTANCE you have no idea about...just cause your friend told you about it doesnt mean its a good idea. Read carefully: THERE IS NO..I REAPEAT NO "BEST" STACK FOR "MAXIMUM" GAINS...Everyones body comp, genetics is different...what might work for me, doesnt mean it will work for you...so QUIT asking for "miracle" cycles PLEASE. Do some research on what you want to take, read read read and read somemore...If you have to ask what PCT is..dont bother in even asking a question...If your a TEENAGER dont bother asking a question...THERE IS NO QUICK FIX TO FAT LOSS....Alot of the Elite members..and by ELITE you know the Bro's im talking about...understand that you dont throw a cutting cycle together and POOF ..fat loss..come on now....you will never EVER achieve your goals if you dont understand how to eat, train and rest...you cant and dont have these down...spend some time learning about it....INJECTING a substance doesnt mean the Muscle Fairy will stop by at night and slap on some muscle or take away some fat..GET THAT CLEAR...only determination and dedication will get you there....That bieng said...read on...
The 17 Most Deadly Mistakes - Even Expert
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1. Lack of General Steroid Education: what you don't know
can hurt you! You need to know what certain types of
steroids do, how to stack and cycle for max results with
minimum risks, injection procedures (you CAN kill yourself
if you don't do this correctly) etc. You need to know the
dangers and how to take steroids safely.
2. Listening to the Wrong Advice: You cannot take anyones
advice without reasearching yoursefl from a reliable source
of information (like this site). Knowledge is Power.
Therefore, one must read as much as possible, gather all
available information, then ask as many questions as
possible. Whatever you do, just don't take advice from the
first guy that comes along.
3. Starting Steroid Use Too Young: This can cause numerous
problems not only physically but mentally, since most 18-20
year olds are not mature enough to handle the elevated test
levels and ignore the media hype of "roid rage", and
physically you can damage permanently growth plates and HPTA
4. Using Counterfeits: Counterfeit steroids are a bigger
problem than you would believe, there are more counterfeit
steroids in the market than you would think. These steroids
offer no positive gains, and some give the side effects of
real steroids. Taking counterfeit steroids is like injecting
poison into your body, bad effects nothing positive.
5. Using Excessive Dosages: When taking steroids, the more
you take is not always the best way to go. Taking excessive
dosages has become a huge problem with steroids today. It
isn't only dangerous, but studies have shown it to be
ineffective. The body can only use a limited amount of the
steroid so the extra is turned into estrogen by the body.
6. Staying On Steroids Too Long: In several cases, steroid
users avoid waring signs telling them not to go on a cycle
more than 8 to 12 weeks without an off period. If an off
period is not taken, there is a higher chance for the
negative effects of steroids to occur. If there is no off
period the body does not have a chance to recover from the
steroids, so more damage is done. This also is terrible for
the kidneys and liver.
7. Eating Poorly: Many people ignore magazines and educators
that explain eating as being an important asset to growing,
but the truth is, eating healthy has a big effect on the
body. When on steroids the user must comsume between 4000
and 7000 calories a day, not meaning eat only fat foods. The
diet must be high in calories and protein, but low in fat.
8. Training Incorrectly: When on steroids the training must
be intense and difficult. Instead of the usual weight that
suits you, you must do excess weight and strenuous work for
the best gains. The workout should involve the maximum
weight possible, and make progress each time.
9. Not Getting Regular Blood Tests: Steroids are very
dangerous and can cause great problems. Blood tests should
be done often and regularly. When steroids are first taken
many tests become elevated but will return to normal with in
a few weeks. During the off period tests should also be done
to make sure the body is recovering properly. If there is a
problem with the Blood test, consult a doctor that you can
trust.
10. Using The Wrong Steroids: Many athletes will increase
their chances of getting negative effects when they take the
wrong steroids. The strongest steroids that build more
muscle mass, have the most side effects. These drugs should
be avoided if possible, unless there is a reason to have an
unbelievable gain. But these drugs are very toxic and we
would recommend not taking them.
11. Not Learning How To Hold On To Your Gains Without
Steroids: Unless you learn how to do this you will never
achieve true long term gains and run the risk of becoming a
"non-stop user".
12. Improper Injection Procedures: This is so important that
it CANNOT be skipped over, the risks of injecting without
knowledge are massive, we personally know of a kid who
nearly killed himself injecting steroids intravenously!
13. Lack Of Preparation and Planning: Not being fully
prepared and having everything you need before you start
your cycle. Not being sure you have time set aside to train
correctly, prepare food, rest etc. Without careful planning
and preparation you will achieve very little. Poor storage
in the home, gym, or where-ever. Poor cycle stacking. Poor
anti-estrogen choices.
14. Starting On Gear For the Wrong Reasons: Because your
friends are doign them. Because you think everyone else in
your gym is on. Thinking that if you use AAS you don't have
to work as hard to gain quality muscle, not thinking about
the consequences before you start, once you start you can
never go back! Being willing to accept the risks associated.
Don't bow to peer pressure, it's your health and your life.
15. Not Being Physically Ready to Start Steroids: Steroids
are not magic, they are the icing on the cake and starting
on them without first having a basic training foundation is
dangerous.
16. Neglecting Personal Security: Not using secure and
discreet online tactics when ordering. Not being security
concious when ordering or researching steroids online
(unencrypted email communications, unsecure websites, not
cleaning your online "footprints", not thinking that the
authorities won't go after the "little guy" as well).
Talking loosely about your steroid use.
17. Sacrificing Overall Health: It's not just about pure
muscle gains, don't forget cardio vascular health,
flexibility, internal organs, muscles, ligaments, testicles,
mental health (steroid obesession - don't let steroids
affect your life and relationships) etc. Thinking that
because your "big" and ripped, that you're actually
functionally strong. Focusing only on "showbiz" mucles and
not on supporting, under-lying ones.
Why should one wait until they've reached their genetic potential
by Zen42
For some it’s about pride and paying dues. Many have shed sweat and blood, persevered through injury and personal sacrifice to build a physique few people will ever achieve. It’s disconcerting to see a newbie walk, take a few pills and then believe they are on the same level. Hard core lifting is more than just knowing and taking the right pharmacology.
For most of us it’s a genuine concern for the newbie. It takes more than gear to get exceptional results.
Before starting you should know your goals...are you looking to increase your strength, improve your looks, become famous, help your career, improve health, improve your self-esteem, get big, get approval or for protection (physical or mental)? The answer to that question determines the paths that are appropriate for you.
Every BODY is different. Do you know how your body acts and reacts? How many calories does it take for you to maintain? What food and feeding schedule can you tolerate? How much water do you need to drink? How much sleep do you need and how much good sleep can you get? What parts of your body respond to higher reps? What parts respond better to lower reps? How many sets give you the best results? What split works best? How many rest days do you need? What medical conditions do you have to adjust for? What exercises work for you and which ones don't? Do you know how to treat your injuries? Do you know how tell if you’re injuring yourself?
Then there are the things that only time and experience can give you: The skill of using dedication and determination to achieve long term goals. The knowledge that you can push yourself past limits, some you didn't even know you had. The experience and knowledge on how to use the equipment properly. The strength to adhere to STRICT form during your lifts. The strength to not give into ego and risk hurting yourself. The strength to adhere to a training program. The knowledge to know when its time to back off and the knowledge to know when to press on. The strength to acknowledge your weaknesses and the wisdom to adjust for them. The knowledge and respect of the dangers of impatience. Additionally, time in the gym gives your bones, tendons and ligaments a chance to strengthen in order to handle the loads additional muscle will require.
By taking the time to learn what your body requires to grow, learning your limitations and strengths, identifying your true goals and developing the skills in the weight room you give yourself the best chance to use steroids successfully.
If you don't do this prep work you put yourself at risk. By not knowing your body, it'll take you longer to realize you need to adjust your dosages. Failing to eat, drink and rest properly will limit your gains. A lack of dedication and determination will waste your effort. An ill prepared body is more prone to soft tissue damage. An ill-informed user is far more likely to use steroids that are wrong for the wanted goal. A person with a weak ego will put themselves at greater risk in and out of the weight room. An inexperienced lifter will be slower to recognize the positive and negative effects of their steroids and not know how to make the appropriate adjustments. An ill-informed lifter will waste a ton of money and possibly a portion of their health.
Steroids offer benefits and risks. Surprisingly little is truly known about how they really work, their interactions and their long-term effects. If a 'newbie' takes the time to develop their base and their knowledge they have a high chance of successfully using steroids to achieve their goals. If they take this time they will be able to take pride in knowing that it really was them that achieved their goals, not what was in the pill or in the syringe.
One thing is certain…you know less than you think you know. (That’s true for all of us.)
Evaluating the Real Health Risks of Anabolic Steroids
While the primary objective of Congress in classifying anabolic steroids as controlled substances (and criminalizing their use) was probably to solve the pharmacologic "cheating" problem in competition sports, the reported health risks associated with these "deadly drugs" provided a seemingly valid basis for the legislation. The reportedly devastating health hazards were used to justify a policy favoring imprisonment of athletes involved with steroids over allowing them to "destroy themselves" with these substances. But would such a policy be appropriate if the real health dangers to healthy adult males were actually significantly less than the members of Congress - and the general public - have been led to believe? An unbiased review of the medical and scientific evidence of risks to healthy adult males is necessary in order to understand and assess the legitimacy of our current national approach to the "steroid problem."
Regrettably, the medical and scientific community has historically been less than truthful in presenting information about anabolic steroids to the general public. For example, for many years their position was that steroids do not build muscle. (For an interesting examination of how study results were engineered to show that steroids do not work through the use of intentionally flawed designs, see, Taylor, 1982, pp. 16-19.) Even as late as 1984, in the highly publicized anti-steroid book Death in the Locker Room: Steroids & Sports (Goldman, 1984), then-medical student Bob Goldman seriously presented his theory about how steroids work in a subchapter devoted to the "placebo effect." It is unclear whether such faulty opinions were based upon ignorance of the overwhelming anecdotal evidence or upon an attempt to protect the public by concealing the truth. Whatever the reason, "[t]he medical community lost much credibility as a result of repeated denials that [steroids] enhance performance" (Yesalis, Kennedy, et al., 1993, p. 1217). Of course, the athletes themselves knew decades earlier about the dramatic effects of anabolics on sports performance and appearance. While today the medical establishment concedes that there is no doubt that anabolic steroids do indeed work (perhaps too well), its previous position created a tremendous distrust within the athletic community and led to an often recognized polarization between the groups which may never be undone.
Regarding anabolic steroid side effects and health hazards, the position of the medical community has been mostly linked to hyperbolic, hysterical works like Death in the Locker Room. The mainstream media, always seeking the sensationalism of a "big story," conveyed such material to the public as if it were gospel truth. With no personal experience to the contrary, the average American accepts this characterization of steroids as dangerous killer drugs. On the other hand, many strength athletes are convinced that doctors and the government advance the "side effect" argument mostly as a scare tactic to preserve the "purity" of athletic competition. They have amassed their own body of underground anecdotal evidence derived from their observations of side effects on themselves and on their peers, or from "underground" treatises on self-administration of steroids. "Athletes using anabolic steroids today have a sophisticated pharmacologic knowledge base for using these agents that surpasses that of the vast majority of physicians. For this reason, traditional warnings regarding the lack of efficacy and the potential dangers of steroid abuse are universally held in contempt. Today, it appears that the experts on anabolic steroid use in athletic competition are not medical clinicians but the athletes [themselves]" (Perry, et al., 1990, p. 422).
A Few Words about Anabolic Steroid Research
Several problems have affected much of the past research into anabolic steroid effects. Until very recently, it was considered unethical for researchers to administer the highly supraphysiologic dosages necessary to simulate use patterns of established steroid users. Therefore, most human studies involved steroid users self-reporting their histories of dosages and duration of use, rather than any controlled administration by the researchers. The reliability problems with this methodology have been noted by experts in the field. Only recently have researchers begun to administer more substantial dosages for short-term periods, simulating the moderate-dose steroid cycles used by some athletes (see, for example: Bhasin, et al., 1996; Hengge et al., 1996).
Another problem plaguing steroid research has been lack of funding. However, the growing interest in anabolic steroids for anti-aging and AIDS therapies may prompt grants for further research. Perhaps the most enlightening research would be retrospective cohort studies examining the health condition, cancer prevalence and mortality statistics of professional bodybuilders from the 1950's, 1960's and 1970's. With such studies, the long-term health ramifications of steroid use finally would be known and quantified. Regrettably, grant proposals to conduct such studies have been repeatedly turned down. Of course, a finding that there are generally no statistically significant long-term adverse effects (especially with moderate dosages and intermittent use) could encourage or increase non-medical steroid use, and might call into question our present national policy of criminalizing steroid users. Consequently, it is unlikely that a strong anti-steroid authority like the National Institute on Drug Abuse, a frequent sponsor of steroid research, will ever approve or fund such a study.
Anabolic Steroid Use by Women and Teenagers
Without question, there are health risks involved in the self-administration of any prescription medicine, particularly in the absence of a physician's advice with respect to dosages and duration of use. Further, without regular monitoring by a doctor, some side effects may go unnoticed or untreated until it is too late. Anabolic steroids can have adverse effects upon the body, and the risks for teenagers and women are higher than for adult males. Since large exogenous doses of androgens are more foreign to a woman's body than to a man's, their effect on the delicate hormonal balance of a woman is more profound. Excessive growth of body hair (hirsutism), coarsening of the skin, male pattern baldness, and deepening of the voice may occur (especially at massive dosages) and are generally not reversible upon discontinuance of steroids. Other possible effects particular to women include heavy facial masculinization, breast tissue reduction, alterations in menstrual cycles, and clitoral enlargement. Legal issues aside, any woman considering the use of high-dose androgens for physical enhancement must seriously weigh the perceived benefits against the quite unappealing potential cosmetic costs.
For teenagers, there is the additional risk of premature closure of the growth plates of the long bones. Even if not for this added risk, the self-administration of anabolics by teenagers must be strongly discouraged. As compared to mature adults, teenagers are much more likely to abuse anabolic steroids to the possible detriment of their health. Generally less focused upon long-range health than adults, more susceptible to peer pressure, and eager for fast results, teenagers are more likely to use anabolics in dangerously high dosages and without any medical supervision. Also, as it is recognized that the effects of anabolics upon size and strength are partially (and sometimes even completely) temporary, teens seem particularly less willing to suffer these post-cycle size and strength reductions, and are more likely to continuously use high-dose steroids for prolonged periods. Even Dan Duchaine, author of the Underground Steroid Handbook II (1989) and a favorite target of the proponents of steroid criminalization, is opposed to steroid use by teenagers. Clearly, even in countries where steroids can be legally obtained without a prescription, it is this writer's opinion that the choice to use them for physical enhancement should be made by mature, informed adults with a pre-established dedication to serious weight-training for several years. Anabolic steroids should never be used by beginning lifters, those with dubious commitments to weight-training, or those simply seeking a substitute for hard work. Parents with suspicions or concerns about their teen children experimenting with anabolics should see Wright & Cowart (1990), Chapter 4, "Recognizing Anabolic Steroid Use in Adolescents," pp. 71 -91. [But as strongly as the juvenile use of anabolics should be discouraged, there is a major question as to whether our nation's present "criminalization" approach is working. See, Do Our Anabolic Steroid Laws Work? section.]
Adverse Effects of Excess Androgens
The average adult male production of testosterone is less than 10 milligrams (mg) per day. Supplemental androgens can raise blood androgen levels to many times the amount that could be naturally produced. All these extra androgens will effect the body's hormonal balance, including the reproductive system. Because anabolics mimic endogenous androgens (i.e., your own natural testosterone) in the negative feedback loop of the hypothalamic-pituitary-gonadal axis, they cause the body to decrease its own production. Exactly how long it takes for the body to begin to shut down its own production of androgens is uncertain, although some have estimated it at about three weeks of steroid therapy. This induced hypogonadal state is characterized by decreased serum testosterone levels, associated testicular atrophy, and impaired sperm production that results in temporary infertility. It is this aspect of anabolic therapy that has been the focus of numerous studies testing the use of anabolics as a form of male contraception. But it is important to note that these effects are reversible with discontinuance of the steroids (Haupt and Rovere, 1984, p. 481), and that no case of permanent sterility as a result of prolonged high-dose steroid consumption has ever been reliably documented (Yesalis and Cowart, 1998, p. 53).
Steroid use can also effect the libido. It is common for the sex drive to heighten during a cycle but decrease toward the end and after because the body's own production of testosterone has been temporarily shut down due to the exogenous steroids. Decreased testicular size is also not uncommon with prolonged usage. Both of these adverse effects are reversible upon the body's own recuperation and often can be avoided altogether with the administration of gonadotropin stimulating drugs, which "jump-start" the body's natural production of testosterone (Phillips, 1991, p. 131; Di Pasquale, 1990, pp. 24-26).
Other adverse effects of excessive androgens upon the body's system of hormones are primarily due to the eventual conversion of the androgens into other compounds. Earlier, we noted that steroid molecules in the body are eventually converted into other compounds or excreted in the urine (see How do Anabolic Steroids Work in the Body? section). Testosterone can be converted by an enzymatic process into a slightly altered derivative hormone called dihydrotestosterone (DHT), a steroid molecule that may be significantly responsible for these adverse effects. Adverse effects of an androgenic nature occur because muscles are not the only parts of the body with receptor sites for steroid molecules, and because a steroid molecule has the potential to deliver several different messages. Which message the steroid molecule delivers depends upon the location of the receptor site to which it links. A steroid molecule linking to a receptor site in a hair follicle may deliver a message to stop growing (leading to male pattern baldness). One linking to a site in a sebaceous gland may deliver a message to produce more oil (leading to acne). One linking to a site in the prostate gland may deliver a message for the gland to enlarge (leading to prostatitis). The occurrence and extent of these adverse effects depend upon the concentration of receptor sites for steroid molecules in that particular area. Each individual is different. For example, male pattern baldness can be exacerbated in athletes who have a genetic predisposition. Steroids with a high conversion rate to DHT seem to be particularly responsible for this adverse effect, and should be avoided. Also, the effect can be partially controlled by the use of finasteride (Proscar or Propecia), a prescription drug which helps to block the conversion of testosterone to DHT.
The appearance of androgenic effects is also largely related to the dosage and to the choice of steroid. Highly androgenic steroids such as testosterone esters, especially in very large doses, will generally be much more prone to cause problems than highly anabolic, less androgenic drugs like methenolone or oxandrolone. However, recent research suggests that the side effects of even highly androgenic compounds have been overstated. There were no significant side effects of 10 weeks of testosterone enanthate at a dosage of 600 mg per week (six times the replacement dose of this highly androgenic ester and more than many bodybuilders might use) (Bhasin,et al.). (In a discouraging kick in the pants to natural athletes everywhere, study participants receiving the testosterone injections without any exercise at all enjoyed significantly greater increases in fat-free mass, arm size and leg size than those who worked out hard but without the steroids.) Other studies have also reported minimal significant androgenic side effects (Pope & Katz, 1994), including one involving the highly androgenic oral steroid oxymetholone (Hengge, et al.). Androgens also have the capacity to be converted into estrogen by chemical reactions and enzymes within certain body tissues. The process by which the steroid molecule is converted to estrogen is called aromatization. Those anabolics that are easily aromatized into estrogen can cause a feminization of the breast tissue known as gynecomastia. While largely dose related, a natural propensity for this condition can cause it to occur even in moderate dosages. This condition can often be avoided or arrested by the judicious use of anti-estrogenic compounds. Once a serious cosmetic problem exists, minor surgery is required to correct it. Numerous professional bodybuilders have had this surgery (Phillips, p. 125) and others obviously need it (look closely at a very top place finisher in the 1998 Mr. Olympia lineup).
Anabolic Steroids and the Liver
Anabolic steroids are processed by the liver. As discussed earlier, C-17 alkylated oral steroids (steroids with an alkyl group added at the alpha position of the "C-17" or number 17 carbon atom of the molecule to withstand total degradation on their first pass through the liver [see Steroids 101 section above]) are unusually harsh on the liver. For this reason, even moderate short-term administration of these C-17 oral steroids can effect liver function test readings. Elevated liver counts indicating liver stress (toxicity) have been reported in recent studies of somewhat moderate oral anabolic steroid therapy (daily doses of 40 and 80 mg of oxandrolone [Oxandrin, formerly Anavar]) as reported in the online periodical Medibolics, edited by Michael Mooney (www.medibolics.com). However, these elevated liver function readings will return to normal after cessation of a moderate, short-term steroid cycle. I could find not one case to the contrary. Further, it is recognized that intense weight training alone often causes changes in liver function tests, including SGOT, SGPT and LDH (this is something that all physicians monitoring athletes using anabolics should be familiar with).
The more serious liver problems attributed to anabolic steroid use include hepatocellular carcinoma (liver cancer) and peliosis hepatitis (blood-filled sacs within the liver). But the majority of cases reporting liver problems have dealt with extremely sick and elderly patients treated with C-17 alkylated oral steroids for years of continuous use, and many of these patients had a particular type of anemia linked to liver tumors even without anabolic steroid therapy. A computer search of the medical literature looking for steroid-associated liver tumors could find only three in athletes (Friedl, 1990). Of the three athletes, one was using 700 mg of oxymetholone a week for five straight years, and one had a tumor more indicative of classic liver cancer than of steroid-associated tumors. Virtually all of the reported liver problems seemed to occur with the 17 alpha-alkylated oral steroids. There have been no cysts or liver tumors reported in athletes using the 17 beta-esterified injectable steroids (Wright & Cowart, p. 61). It has been noted that injectable steroids generally appear to have little effect on the liver at all (Haupt, 1993, p. 469).
Recent studies continue to suggest that reports of serious adverse effects of anabolic steroids upon the liver in healthy athletes may be highly overstated. In a study of athletes, of the 53 current or past steroid users who underwent laboratory testing, only one subject displayed an abnormal liver test (Pope & Katz, 1994, p. 379; incidentally, on physical examination, not one user displayed evidence of any major abnormalities possibly attributable to steroids, such as high blood pressure, edema, acne or hair loss.) Another study tested one of the most powerful and reputedly dangerously toxic anabolic steroids for 30 weeks on HIV positive men and women (Hengge et al.). Oxymetholone, formerly known as Anadrol in the U.S. and a C-17 alkylated oral steroid, was administered in a dosage of over 1,000 mg per week (more than that used by many bodybuilders, and for a much longer duration of uninterrupted use). The results were significant gains in lean muscle mass -- even without any weightlifting. Even more importantly - and surprisingly -- there were no significant problems with liver function, water retention, or virilization side effects (it will be interesting to see whether further studies yield consistent findings at such high dosages).
While the dangers of anabolics to athletes' livers appear to have been highly exaggerated, it must be recognized that an apparently healthy athlete with a previously existing but undiscovered liver problem could do serious damage to himself by self-administering C-17 oral anabolic steroids. For this reason alone, it would be quite irresponsible for any athlete to use anabolic steroids without having a physician regularly conduct blood tests to monitor liver function.
Anabolic Steroids and the Heart
How cardiac risk might be increased by the use of steroids is a subject of speculation and some controversy. High blood pressure is perhaps "one of the most exaggerated claims" of steroid-related health risks, and remains unconfirmed despite numerous studies (Friedl, 1993, pp. 119-120). Regarding blood lipid levels, oral steroids in particular seem to cause a reduction in HDL (high-density lipoprotein cholesterol) levels in some steroid users. However, changes in the blood lipid levels now appear to begin to recover within about a month after discontinued use, and, in fact, most studies do not report an increase in total cholesterol (Yesalis & Cowart, p. 54).
In examining cardiovascular risks, often cited is a case report by (R.A. McNutt, et al, 1988), concerning a 22-year-old steroid-using weightlifter who experienced a sudden heart attack. While often held out by anti-steroid authorities as the "smoking gun" connecting steroid use to heart attacks, a reading of the actual report reveals that the subject weighed 330 pounds and had a total serum cholesterol of a whopping 596 mg/dl! The fact that so few similar case studies exist may well indicate that the condition of this individual was hardly representative of the majority of athletes who use steroids. (Nonetheless, all strength athletes, including steroid users, should regularly monitor serum cholesterol. Obviously, this poor fellow didn't get his cholesterol to 596 overnight, and it is not reported when he last visited a physician prior to his heart attack. To what extent our nation's criminalization approach to steroids, which discourages steroid-users from seeing doctors, contributed to this result is open to speculation.)
While the question of whether short-term, reversible alterations of these cardiac risk factors are detrimental to long-term cardiac health is "unanswered" at this time (Haupt, p. 469), it has been suggested that some characteristics of steroid-users - intense exercising, low body fat, and avoidance of smoking -- tend to put them in a low-risk group for heart disease (Friedl, 1993, p. 120).
Based on our present information, cardiac risks seem to be primarily related to high dosages in the absence of physician monitoring. Jose Antonio, PhD., a nationally recognized authority on drugs in sports who has written a monthly column for Flex magazine, cites a study examining serious cardiovascular side effects in four weightlifters using "massive amounts" of steroids (Antonio, 1998). While there is little doubt that the health problems of these men were caused by their anabolic steroid abuse, these were clearly mega-dose abusers. "[H]igh dose equals high risk," notes Dr. Antonio, but "low-dose androgens (e.g., 200-600 mg per week for 10 weeks) pose little threat to health."
Anabolic Steroids and the Prostate
A legitimate concern is the potential adverse effect of excessive androgens on the prostate gland. While there is one case report of prostate cancer in a bodybuilder (Roberts & Essenhigh, 1986), no studies have shown an increased risk or incidence of prostatic cancer or hypertrophy with androgen use or indicated that androgens per se predispose to these conditions (Swerdloff & Wang, 1993). Numerous male contraceptive studies using up to 200 mg/week for over a year show no evidence of prostate stimulation. Researchers at the University of Iowa recently examined the prostate effects of the administration for 15 weeks of up to 500 mg/week to healthy men in their twenties and thirties (Cooper, et al., 1998, pp. 441-43). No changes in prostate size or serum prostate specific antigen (PSA) levels were detected either during or up to 25 weeks after the last dose. Further, androgens are not the only or even the main causative factor in prostate cancer, as evinced by a case study in which a chronically testosterone deficient man developed prostate cancer (Boccon, 1991, et al.). Warning: this does not necessarily mean that much higher dosages, especially of highly androgenic compounds, might not adversely effect the prostate, especially in older men. It is not known if athletes who have used steroids for prolonged periods will encounter more prostatic problems as they age (Di Pasquale, 1990, p. 62).
Anabolic Steroids and Aggressive/Psychiatric Symptoms
Enormous media attention has been focused upon the reported adverse psychiatric effects (especially violent behavior) of steroid use. "Roid rage" is the descriptive term for steroid-induced "spontaneous, highly aggressive, out-of-control behavior where the police either were called or should have intervened" (Yesalis & Cowart, p. 60). A few researchers have suggested that psychiatric symptoms including increased aggression are a common side effect of anabolic steroid use. For example, a flawed 1988 study suggested that psychiatric disorders occur with unusual frequency among athletes using anabolics (Pope & Katz, 1988, pp. 487-490). But the conclusions of these researchers have been regarded with skepticism by other experts (see, Lubell, 1989, comments of Dr. James Wright and Dr. Charles Yesalis at 178). "If this phenomenon is real, it is relatively rare (probably less than 1 percent) among steroid users. Even among those affected, the impact of previous mental illness or abuse of other drugs is still unclear" (Yesalis & Cowart, p. 60). "Some long-time steroid users have never suffered any emotional instability, or anything more than transient physical effects" and many steroid users describe non-violent feelings of euphoria, well-being and enhanced self-confidence as common effects (Wright & Cowart, p. 51). In one study to determine the psychiatric effects of steroid use on athletes, no significant differences could be found between users and non-users. "The facts that steroids have been used by tens of thousands if not hundreds of thousands of athletes over two decades and that behavioral effects are only recently being discovered (in small numbers) tend to support [that feelings of aggression may not be observed in the majority of steroid users]. Our findings are compatible with and complementary to those in anecdotal reports and data from individual psychiatrists" (Bahrke, et al., 1990, pp. 834-835). The researchers do not rule out, however, the possibility that in a small minority of predisposed individuals, "steroid use may be sufficient to push them over the edge and contribute to irrational or violent behavior." Many experienced steroid users have found that steroids enhance certain preexisting personality problems. Angry and combative users will become angrier and more combative; however, while normal guys will train more aggressively, they won't generally become violent.
Not surprisingly, when psychiatric problems do occur in study subjects, there seems to be a direct correlation between dosage and prevalence of syndromes. For example, no significant psychiatric effects have been noted where reported mean weekly dosage was 318 mg (heaviest user was 620 mg/wk) (Bahrke, et al., 1992, p. 717). But where reported dosage exceeded 1,000 mg/wk, 11 out of 25 subjects (44%) exhibited mood disorders (Pope & Katz, 1994, p. 380). While, based on this and other studies, there is a dose-related correlation between steroid use and psychiatric effects, it must be noted that not all steroid users exhibit such symptoms; in fact, nearly 90% of light and moderate dosage users in this particular study exhibited no mood disorder symptoms at all.
The psychiatric effect that massive amounts of anabolics might have upon predisposed individuals has created a new defense in criminal cases (see, Lubell). Just as voluntary alcohol intoxication can be used to negate the specific intent required for certain crimes, so has voluntary ingestion of anabolic steroids been offered in the defense of various violent crimes in an effort to prove that the accused was unable to distinguish right from wrong or to understand the consequences of his acts. A sampling of these cases reveals, generally, that such defenses were unsuccessfully raised. This may be due in part to the fact that in many cases the dosages administered were either not specified or were too low to be persuasive. A bigger factor may be the general reluctance of juries to acquit in murder cases based on insanity defenses, especially where the insanity was caused by a voluntarily consumed substance.
Anabolic Steroids and Psychological Dependence
There is some evidence that anabolic steroid use can lead to psychological dependence in certain individuals. Whether the dependence is due to chemical effects upon the brain or simply because of the positive reinforcement occasioned by a more muscular physique is not known. Whatever the cause, this may be the most dangerous aspect of steroid use for those it affects. The cessation of steroid use, especially after a prolonged cycle, often leaves the user in a state of low endogenous testosterone levels. For individuals with an inadequate sense of self, the loss of some portion of the steroid gains can be psychologically devastating to the ego. These individuals can be unable to resist immediately resuming steroid use. Further, as the goal of hardcore bodybuilders is not optimal muscle size, but maximal muscle size, dosages can become excessive. While many athletes successfully use steroids intermittently and with moderation, it is a sobering thought that there are certain individuals who start out on low risk, short-term cycles and ultimately end up using massive dosages for years of uninterrupted use. It might be theorized that the problem of dependence on steroids by certain bodybuilders has less to do with the nature of the substance than with the psychological profile of the users.
Other Adverse Effects of Anabolic Steroids
Connective tissue injuries. The medical literature regarding the suggestion of increased athletic injuries caused by anabolic steroid use is scant (Di Pasquale, August 1992, pp. 12-13). It is not unreasonable to expect muscle and tendon tears in hardcore strength athletes, regardless of steroid use. However, the exceptional frequency and severity (often requiring surgical reattachment) of such injuries in professional level bodybuilders do raise suspicions as to the possibility that steroids, diuretics, or other drugs may be implicated. Former Mr. Olympia Dorian Yates has suffered training-related injuries to the chest, leg and biceps, and retired after a major triceps injury. Pro bodybuilder Alq Gurley reportedly completely tore the quadriceps muscles in both legs when he fell while simply walking! Whether these injuries are steroid-related is as yet unknown, although some animal studies have suggested that steroids may cause tendon degeneration and increased risk of tendon rupture. It may not be unreasonable to assume that, like many adverse steroid effects, connective tissue injuries are mostly associated with high-dose, prolonged usage.
AIDS. Many articles include this as a possible consequence. Quite frankly, anyone who would even consider sharing needles with his gym buddies in this day and age is so irresponsible and judgment-impaired that the substance of this entire article is lost on him.
Premature Closure of Growth Plates. Chronic steroid usage prior to puberty or in early adolescence can cause premature closure of the growth plates of the long bones, preventing the young user from attaining full natural height. For this reason as well as others previously discussed, teenagers should not use steroids for muscle building.
The Dangers of Counterfeit Steroids
One of the primary effects of our government's crackdown on legitimate anabolic steroids has been the expansion of a huge black market of counterfeit products. While estimates vary widely, many authorities assert that the majority of anabolics available on the black market are fakes. These counterfeits are manufactured under unsupervised and potentially unsanitary conditions, and may contain no real androgens at all (see, Di Pasquale, 1995). They may also be contaminated with bacteria or other dangerous substances. Noted steroid expert Dr. Robert Price: "My colleagues at Mount Sinai Hospital in New York tell me they are treating many more athletes for side effects of counterfeit and bogus steroids than they did when reliable pharmacy-purchased steroids were available" (Allen, 1998, p. 224).
If the health dangers of real anabolic steroids have been overstated, the dangers of counterfeit anabolics may be understated. The problem is particularly serious because of how difficult it is to distinguish a real product from a counterfeit knock-off. As an example of these very subtle differences, compare legitimate versus counterfeit Anapolon 50 tablets by Syntex (Grunding & Bachmann, 1996, pp. 349-351, photographs at 357-358, 361).
Conclusion
It can be concluded that "[a]s used by most athletes, the side effects of anabolic steroid use appear to be minimal" (Di Pasquale, 1990, p. 5). Despite over forty years of use by athletes, many of whom are now well into middle-age, we have yet to hear reports of an epidemic of steroid-related deaths. A review of the medical literature does not support the depiction of a serious health crisis related to anabolic steroids. Of course, it would be untrue to say that anabolic steroids, especially black market products, are safe for unsupervised, unmonitored self-administration. On the other hand, it would be equally untrue to say that anabolics are "deadly drugs" deserving of the imposition of harsh criminal penalties for personal use by adults. Accordingly, there is a serious question as to whether Congress may have grossly overreacted in addressing the non-medical use of anabolic steroids by athletes. For further discussion of this issue, and why dispensing steroids should be put back in the hands of trained physicians instead of the black market's dubious "experts," see the section entitled Do Our Anabolic Steroid Laws Work?.
Reference Sources
In addition to the published sources listed below, this writer was assisted by correspondences with authorities in the field. I would like to express appreciation to Dr. Don Catlin, Dr. Mauro Di Pasquale, Michael Mooney and Dr. Charles Yesalis for their time and assistance.
Allen, B., "Steroid-using Athletes and Liver Function," MuscleMag International (Vol.191, May, 1998) p. 129.
Antonio, J., Flex, Vol. 16, No. 3 (May 1998), p. 240, citing 17 European Heart Journal (1996), pp. 1576-83.
Bahrke, M.S., Wright, J.E., O'Connor, J.S., et al., "Selected Psychological Characteristics of Anabolic-androgenic Steroid Users, 323 N Engl J Med 12 (1990), pp. 834-835.
Bahrke, M.S., Wright, J.E., Strauss, R.H., Catlin D.H., "Psychological Moods and Subjectively Perceived Behavioral and Somatic Changes Accompanying Anabolic-Androgenic Steroid Use," 20 Am J Sports Med (1992), p. 717.
Bhasin, S., Storer, T.W., Berman N., et al., "The Effects of Supraphysiologic Doses of Testosterone on Muscle Size and Strength in Normal Men," 335 N Engl J Med (July 4, 1996), pp. 1-7.
Boccon, G.L., Dauge, M.C., et al., "Prostate Cancer in a 75-year-old Man after Four Decades of Testosterone Androgen Deprivation," 20 Eur Urol 1 (1991), pp. 81-88.
Brower, K., "Anabolic Steroids: Potential for Physical and Psychological Dependence," C.E. Yesalis (Ed.), Anabolic Steroids in Sports and Exercise (Champaign, IL; Human Kinetics, 1993), pp. 193-213.
Cooper, C.S., et al., "Effect of Exogenous Testosterone on Prostate Volume, Serum and Semen Prostate Specific Antigen Levels in Healthy Young Men," 159 J of Urology, 2 (1998), pp. 441-43.
Di Pasquale, M.G., Anabolic Steroid Side Effects: Facts, Fiction and Treatment (M.G.D. Press; Warkworth, Ontario, 1990).
Di Pasquale, M.G., "Does the Use of Anabolic Steroids Increase Athletic Injuries?" 1 Drugs in Sports 3 (August, 1992).
Di Pasquale, M.G., "Black Market Drugs," 1 Anabolic Research Review 1 (1995).
Duchaine, D., Underground Steroid Handbook II (HLR Technical Books; Venice CA, 1989).
Friedl, K.E., "Reappraisal of the health risks associated with the use of high doses of oral and injectable androgenic steroids," in G.C. Lin & L. Erinoff (Eds.), Anabolic Steroid Abuse (Washington, D.C.; U.S. Government Printing Office, 1990), pp. 142-177.
Friedl, K.E., "Effects of Anabolic Steroids on Physical Health," in C.E. Yesalis (Ed.), Anabolic Steroids in Sport and Exercise (Champaign, IL; Human Kinetics, 1993), pp. 119-120.
Goldman, R., Death in the Locker Room: Steroids & Sports (South Bend, IN; Icarus Press, 1984).
Grunding, P., & Bachmann, M., World Anabolic Review 1996 (Houston, TX; MB Muscle Books, 1995).
Haupt, H.A., "Anabolic Steroids and Growth Hormone," 21 Amer. J. of Sports Med., 3 (1993), p. 468.
Haupt, H.A. and Rovere, G.D., "Anabolic Steroids: a Review of the Literature," 12 Amer. J. of Sports Med., 6 (1984), p. 469.
Hengge, U.R., et al., "Oxymetholone promotes Weight Gain in Patients with Advanced Human Immunodeficiency Virus (HIV-1) Infection," 75 Brit J Nutri (1996), pp. 129-138.
Lubell, A., "Does Steroid Abuse Cause - Or Excuse - Violence?" 17 The Physician And Sportsmedicine, 2 (1989), pp. 176-185.
McNutt, R.A., et al, "Acute Myocardial Infarction in a 22-year-old World Class Weight Lifter using Anabolic Steroids," 62 Amer J of Cardiology (1988), p. 164.
Perry, P.J., Andersen, K.H., and Yates, W.R., "Illicit Anabolic Steroid Use in Athletes," 18 Amer. J. of Sports Med., 4 (1990), p. 422.
Phillips, W.N., Anabolic Reference Guide (Sixth Edition, Golden CO.; Mile High Publishing, 1991).
Pope, H.G., & Katz, D.L., "Affective and Psychotic Symptoms Associated with Anabolic Steroid Use," 145 Am J of Psychiatry, 4 (Apr. 1988), pp. 487-490.
Pope, H.G., & Katz, D.L., "Psychiatric and Medical effects of Anabolic-Androgenic Steroid Use," 51 Arch. Gen. Psychiatry (1994), pp. 375-382.
Roberts, J., & Essenhigh, D., "Adenocarcinoma of prostate in 40-year-old body-builder," 2 Lancet (1986), p. 742.
Swerdloff, R.S., & Wang, C., "Androgen Deficiency and Aging in Men," 159 West J Med (1993), pp. 579-585.
Taylor, W.N., Anabolic Steroids and the Athlete (Jefferson, NC; McFarland & Co., 1982).
Wright, J.E., and Cowart, V.S., Anabolic Steroids: Altered States (Carmel, IN: Benchmark Press, 1990).
Yesalis, C.E., & Cowart, V.S., The Steroids Game (Champaign, IL; Human Kinetics, 1998).
Yesalis, C.E., Kennedy, N.J., Kopstein, A.N., Bahrke, M.S., "Anabolic-Androgenic Steroid Use in the United States," 270 JAMA, 10 (Sept. 8, 1993), p. 1217.
The 17 Most Deadly Mistakes - Even Expert
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1. Lack of General Steroid Education: what you don't know
can hurt you! You need to know what certain types of
steroids do, how to stack and cycle for max results with
minimum risks, injection procedures (you CAN kill yourself
if you don't do this correctly) etc. You need to know the
dangers and how to take steroids safely.
2. Listening to the Wrong Advice: You cannot take anyones
advice without reasearching yoursefl from a reliable source
of information (like this site). Knowledge is Power.
Therefore, one must read as much as possible, gather all
available information, then ask as many questions as
possible. Whatever you do, just don't take advice from the
first guy that comes along.
3. Starting Steroid Use Too Young: This can cause numerous
problems not only physically but mentally, since most 18-20
year olds are not mature enough to handle the elevated test
levels and ignore the media hype of "roid rage", and
physically you can damage permanently growth plates and HPTA
4. Using Counterfeits: Counterfeit steroids are a bigger
problem than you would believe, there are more counterfeit
steroids in the market than you would think. These steroids
offer no positive gains, and some give the side effects of
real steroids. Taking counterfeit steroids is like injecting
poison into your body, bad effects nothing positive.
5. Using Excessive Dosages: When taking steroids, the more
you take is not always the best way to go. Taking excessive
dosages has become a huge problem with steroids today. It
isn't only dangerous, but studies have shown it to be
ineffective. The body can only use a limited amount of the
steroid so the extra is turned into estrogen by the body.
6. Staying On Steroids Too Long: In several cases, steroid
users avoid waring signs telling them not to go on a cycle
more than 8 to 12 weeks without an off period. If an off
period is not taken, there is a higher chance for the
negative effects of steroids to occur. If there is no off
period the body does not have a chance to recover from the
steroids, so more damage is done. This also is terrible for
the kidneys and liver.
7. Eating Poorly: Many people ignore magazines and educators
that explain eating as being an important asset to growing,
but the truth is, eating healthy has a big effect on the
body. When on steroids the user must comsume between 4000
and 7000 calories a day, not meaning eat only fat foods. The
diet must be high in calories and protein, but low in fat.
8. Training Incorrectly: When on steroids the training must
be intense and difficult. Instead of the usual weight that
suits you, you must do excess weight and strenuous work for
the best gains. The workout should involve the maximum
weight possible, and make progress each time.
9. Not Getting Regular Blood Tests: Steroids are very
dangerous and can cause great problems. Blood tests should
be done often and regularly. When steroids are first taken
many tests become elevated but will return to normal with in
a few weeks. During the off period tests should also be done
to make sure the body is recovering properly. If there is a
problem with the Blood test, consult a doctor that you can
trust.
10. Using The Wrong Steroids: Many athletes will increase
their chances of getting negative effects when they take the
wrong steroids. The strongest steroids that build more
muscle mass, have the most side effects. These drugs should
be avoided if possible, unless there is a reason to have an
unbelievable gain. But these drugs are very toxic and we
would recommend not taking them.
11. Not Learning How To Hold On To Your Gains Without
Steroids: Unless you learn how to do this you will never
achieve true long term gains and run the risk of becoming a
"non-stop user".
12. Improper Injection Procedures: This is so important that
it CANNOT be skipped over, the risks of injecting without
knowledge are massive, we personally know of a kid who
nearly killed himself injecting steroids intravenously!
13. Lack Of Preparation and Planning: Not being fully
prepared and having everything you need before you start
your cycle. Not being sure you have time set aside to train
correctly, prepare food, rest etc. Without careful planning
and preparation you will achieve very little. Poor storage
in the home, gym, or where-ever. Poor cycle stacking. Poor
anti-estrogen choices.
14. Starting On Gear For the Wrong Reasons: Because your
friends are doign them. Because you think everyone else in
your gym is on. Thinking that if you use AAS you don't have
to work as hard to gain quality muscle, not thinking about
the consequences before you start, once you start you can
never go back! Being willing to accept the risks associated.
Don't bow to peer pressure, it's your health and your life.
15. Not Being Physically Ready to Start Steroids: Steroids
are not magic, they are the icing on the cake and starting
on them without first having a basic training foundation is
dangerous.
16. Neglecting Personal Security: Not using secure and
discreet online tactics when ordering. Not being security
concious when ordering or researching steroids online
(unencrypted email communications, unsecure websites, not
cleaning your online "footprints", not thinking that the
authorities won't go after the "little guy" as well).
Talking loosely about your steroid use.
17. Sacrificing Overall Health: It's not just about pure
muscle gains, don't forget cardio vascular health,
flexibility, internal organs, muscles, ligaments, testicles,
mental health (steroid obesession - don't let steroids
affect your life and relationships) etc. Thinking that
because your "big" and ripped, that you're actually
functionally strong. Focusing only on "showbiz" mucles and
not on supporting, under-lying ones.
Why should one wait until they've reached their genetic potential
by Zen42
For some it’s about pride and paying dues. Many have shed sweat and blood, persevered through injury and personal sacrifice to build a physique few people will ever achieve. It’s disconcerting to see a newbie walk, take a few pills and then believe they are on the same level. Hard core lifting is more than just knowing and taking the right pharmacology.
For most of us it’s a genuine concern for the newbie. It takes more than gear to get exceptional results.
Before starting you should know your goals...are you looking to increase your strength, improve your looks, become famous, help your career, improve health, improve your self-esteem, get big, get approval or for protection (physical or mental)? The answer to that question determines the paths that are appropriate for you.
Every BODY is different. Do you know how your body acts and reacts? How many calories does it take for you to maintain? What food and feeding schedule can you tolerate? How much water do you need to drink? How much sleep do you need and how much good sleep can you get? What parts of your body respond to higher reps? What parts respond better to lower reps? How many sets give you the best results? What split works best? How many rest days do you need? What medical conditions do you have to adjust for? What exercises work for you and which ones don't? Do you know how to treat your injuries? Do you know how tell if you’re injuring yourself?
Then there are the things that only time and experience can give you: The skill of using dedication and determination to achieve long term goals. The knowledge that you can push yourself past limits, some you didn't even know you had. The experience and knowledge on how to use the equipment properly. The strength to adhere to STRICT form during your lifts. The strength to not give into ego and risk hurting yourself. The strength to adhere to a training program. The knowledge to know when its time to back off and the knowledge to know when to press on. The strength to acknowledge your weaknesses and the wisdom to adjust for them. The knowledge and respect of the dangers of impatience. Additionally, time in the gym gives your bones, tendons and ligaments a chance to strengthen in order to handle the loads additional muscle will require.
By taking the time to learn what your body requires to grow, learning your limitations and strengths, identifying your true goals and developing the skills in the weight room you give yourself the best chance to use steroids successfully.
If you don't do this prep work you put yourself at risk. By not knowing your body, it'll take you longer to realize you need to adjust your dosages. Failing to eat, drink and rest properly will limit your gains. A lack of dedication and determination will waste your effort. An ill prepared body is more prone to soft tissue damage. An ill-informed user is far more likely to use steroids that are wrong for the wanted goal. A person with a weak ego will put themselves at greater risk in and out of the weight room. An inexperienced lifter will be slower to recognize the positive and negative effects of their steroids and not know how to make the appropriate adjustments. An ill-informed lifter will waste a ton of money and possibly a portion of their health.
Steroids offer benefits and risks. Surprisingly little is truly known about how they really work, their interactions and their long-term effects. If a 'newbie' takes the time to develop their base and their knowledge they have a high chance of successfully using steroids to achieve their goals. If they take this time they will be able to take pride in knowing that it really was them that achieved their goals, not what was in the pill or in the syringe.
One thing is certain…you know less than you think you know. (That’s true for all of us.)
Evaluating the Real Health Risks of Anabolic Steroids
While the primary objective of Congress in classifying anabolic steroids as controlled substances (and criminalizing their use) was probably to solve the pharmacologic "cheating" problem in competition sports, the reported health risks associated with these "deadly drugs" provided a seemingly valid basis for the legislation. The reportedly devastating health hazards were used to justify a policy favoring imprisonment of athletes involved with steroids over allowing them to "destroy themselves" with these substances. But would such a policy be appropriate if the real health dangers to healthy adult males were actually significantly less than the members of Congress - and the general public - have been led to believe? An unbiased review of the medical and scientific evidence of risks to healthy adult males is necessary in order to understand and assess the legitimacy of our current national approach to the "steroid problem."
Regrettably, the medical and scientific community has historically been less than truthful in presenting information about anabolic steroids to the general public. For example, for many years their position was that steroids do not build muscle. (For an interesting examination of how study results were engineered to show that steroids do not work through the use of intentionally flawed designs, see, Taylor, 1982, pp. 16-19.) Even as late as 1984, in the highly publicized anti-steroid book Death in the Locker Room: Steroids & Sports (Goldman, 1984), then-medical student Bob Goldman seriously presented his theory about how steroids work in a subchapter devoted to the "placebo effect." It is unclear whether such faulty opinions were based upon ignorance of the overwhelming anecdotal evidence or upon an attempt to protect the public by concealing the truth. Whatever the reason, "[t]he medical community lost much credibility as a result of repeated denials that [steroids] enhance performance" (Yesalis, Kennedy, et al., 1993, p. 1217). Of course, the athletes themselves knew decades earlier about the dramatic effects of anabolics on sports performance and appearance. While today the medical establishment concedes that there is no doubt that anabolic steroids do indeed work (perhaps too well), its previous position created a tremendous distrust within the athletic community and led to an often recognized polarization between the groups which may never be undone.
Regarding anabolic steroid side effects and health hazards, the position of the medical community has been mostly linked to hyperbolic, hysterical works like Death in the Locker Room. The mainstream media, always seeking the sensationalism of a "big story," conveyed such material to the public as if it were gospel truth. With no personal experience to the contrary, the average American accepts this characterization of steroids as dangerous killer drugs. On the other hand, many strength athletes are convinced that doctors and the government advance the "side effect" argument mostly as a scare tactic to preserve the "purity" of athletic competition. They have amassed their own body of underground anecdotal evidence derived from their observations of side effects on themselves and on their peers, or from "underground" treatises on self-administration of steroids. "Athletes using anabolic steroids today have a sophisticated pharmacologic knowledge base for using these agents that surpasses that of the vast majority of physicians. For this reason, traditional warnings regarding the lack of efficacy and the potential dangers of steroid abuse are universally held in contempt. Today, it appears that the experts on anabolic steroid use in athletic competition are not medical clinicians but the athletes [themselves]" (Perry, et al., 1990, p. 422).
A Few Words about Anabolic Steroid Research
Several problems have affected much of the past research into anabolic steroid effects. Until very recently, it was considered unethical for researchers to administer the highly supraphysiologic dosages necessary to simulate use patterns of established steroid users. Therefore, most human studies involved steroid users self-reporting their histories of dosages and duration of use, rather than any controlled administration by the researchers. The reliability problems with this methodology have been noted by experts in the field. Only recently have researchers begun to administer more substantial dosages for short-term periods, simulating the moderate-dose steroid cycles used by some athletes (see, for example: Bhasin, et al., 1996; Hengge et al., 1996).
Another problem plaguing steroid research has been lack of funding. However, the growing interest in anabolic steroids for anti-aging and AIDS therapies may prompt grants for further research. Perhaps the most enlightening research would be retrospective cohort studies examining the health condition, cancer prevalence and mortality statistics of professional bodybuilders from the 1950's, 1960's and 1970's. With such studies, the long-term health ramifications of steroid use finally would be known and quantified. Regrettably, grant proposals to conduct such studies have been repeatedly turned down. Of course, a finding that there are generally no statistically significant long-term adverse effects (especially with moderate dosages and intermittent use) could encourage or increase non-medical steroid use, and might call into question our present national policy of criminalizing steroid users. Consequently, it is unlikely that a strong anti-steroid authority like the National Institute on Drug Abuse, a frequent sponsor of steroid research, will ever approve or fund such a study.
Anabolic Steroid Use by Women and Teenagers
Without question, there are health risks involved in the self-administration of any prescription medicine, particularly in the absence of a physician's advice with respect to dosages and duration of use. Further, without regular monitoring by a doctor, some side effects may go unnoticed or untreated until it is too late. Anabolic steroids can have adverse effects upon the body, and the risks for teenagers and women are higher than for adult males. Since large exogenous doses of androgens are more foreign to a woman's body than to a man's, their effect on the delicate hormonal balance of a woman is more profound. Excessive growth of body hair (hirsutism), coarsening of the skin, male pattern baldness, and deepening of the voice may occur (especially at massive dosages) and are generally not reversible upon discontinuance of steroids. Other possible effects particular to women include heavy facial masculinization, breast tissue reduction, alterations in menstrual cycles, and clitoral enlargement. Legal issues aside, any woman considering the use of high-dose androgens for physical enhancement must seriously weigh the perceived benefits against the quite unappealing potential cosmetic costs.
For teenagers, there is the additional risk of premature closure of the growth plates of the long bones. Even if not for this added risk, the self-administration of anabolics by teenagers must be strongly discouraged. As compared to mature adults, teenagers are much more likely to abuse anabolic steroids to the possible detriment of their health. Generally less focused upon long-range health than adults, more susceptible to peer pressure, and eager for fast results, teenagers are more likely to use anabolics in dangerously high dosages and without any medical supervision. Also, as it is recognized that the effects of anabolics upon size and strength are partially (and sometimes even completely) temporary, teens seem particularly less willing to suffer these post-cycle size and strength reductions, and are more likely to continuously use high-dose steroids for prolonged periods. Even Dan Duchaine, author of the Underground Steroid Handbook II (1989) and a favorite target of the proponents of steroid criminalization, is opposed to steroid use by teenagers. Clearly, even in countries where steroids can be legally obtained without a prescription, it is this writer's opinion that the choice to use them for physical enhancement should be made by mature, informed adults with a pre-established dedication to serious weight-training for several years. Anabolic steroids should never be used by beginning lifters, those with dubious commitments to weight-training, or those simply seeking a substitute for hard work. Parents with suspicions or concerns about their teen children experimenting with anabolics should see Wright & Cowart (1990), Chapter 4, "Recognizing Anabolic Steroid Use in Adolescents," pp. 71 -91. [But as strongly as the juvenile use of anabolics should be discouraged, there is a major question as to whether our nation's present "criminalization" approach is working. See, Do Our Anabolic Steroid Laws Work? section.]
Adverse Effects of Excess Androgens
The average adult male production of testosterone is less than 10 milligrams (mg) per day. Supplemental androgens can raise blood androgen levels to many times the amount that could be naturally produced. All these extra androgens will effect the body's hormonal balance, including the reproductive system. Because anabolics mimic endogenous androgens (i.e., your own natural testosterone) in the negative feedback loop of the hypothalamic-pituitary-gonadal axis, they cause the body to decrease its own production. Exactly how long it takes for the body to begin to shut down its own production of androgens is uncertain, although some have estimated it at about three weeks of steroid therapy. This induced hypogonadal state is characterized by decreased serum testosterone levels, associated testicular atrophy, and impaired sperm production that results in temporary infertility. It is this aspect of anabolic therapy that has been the focus of numerous studies testing the use of anabolics as a form of male contraception. But it is important to note that these effects are reversible with discontinuance of the steroids (Haupt and Rovere, 1984, p. 481), and that no case of permanent sterility as a result of prolonged high-dose steroid consumption has ever been reliably documented (Yesalis and Cowart, 1998, p. 53).
Steroid use can also effect the libido. It is common for the sex drive to heighten during a cycle but decrease toward the end and after because the body's own production of testosterone has been temporarily shut down due to the exogenous steroids. Decreased testicular size is also not uncommon with prolonged usage. Both of these adverse effects are reversible upon the body's own recuperation and often can be avoided altogether with the administration of gonadotropin stimulating drugs, which "jump-start" the body's natural production of testosterone (Phillips, 1991, p. 131; Di Pasquale, 1990, pp. 24-26).
Other adverse effects of excessive androgens upon the body's system of hormones are primarily due to the eventual conversion of the androgens into other compounds. Earlier, we noted that steroid molecules in the body are eventually converted into other compounds or excreted in the urine (see How do Anabolic Steroids Work in the Body? section). Testosterone can be converted by an enzymatic process into a slightly altered derivative hormone called dihydrotestosterone (DHT), a steroid molecule that may be significantly responsible for these adverse effects. Adverse effects of an androgenic nature occur because muscles are not the only parts of the body with receptor sites for steroid molecules, and because a steroid molecule has the potential to deliver several different messages. Which message the steroid molecule delivers depends upon the location of the receptor site to which it links. A steroid molecule linking to a receptor site in a hair follicle may deliver a message to stop growing (leading to male pattern baldness). One linking to a site in a sebaceous gland may deliver a message to produce more oil (leading to acne). One linking to a site in the prostate gland may deliver a message for the gland to enlarge (leading to prostatitis). The occurrence and extent of these adverse effects depend upon the concentration of receptor sites for steroid molecules in that particular area. Each individual is different. For example, male pattern baldness can be exacerbated in athletes who have a genetic predisposition. Steroids with a high conversion rate to DHT seem to be particularly responsible for this adverse effect, and should be avoided. Also, the effect can be partially controlled by the use of finasteride (Proscar or Propecia), a prescription drug which helps to block the conversion of testosterone to DHT.
The appearance of androgenic effects is also largely related to the dosage and to the choice of steroid. Highly androgenic steroids such as testosterone esters, especially in very large doses, will generally be much more prone to cause problems than highly anabolic, less androgenic drugs like methenolone or oxandrolone. However, recent research suggests that the side effects of even highly androgenic compounds have been overstated. There were no significant side effects of 10 weeks of testosterone enanthate at a dosage of 600 mg per week (six times the replacement dose of this highly androgenic ester and more than many bodybuilders might use) (Bhasin,et al.). (In a discouraging kick in the pants to natural athletes everywhere, study participants receiving the testosterone injections without any exercise at all enjoyed significantly greater increases in fat-free mass, arm size and leg size than those who worked out hard but without the steroids.) Other studies have also reported minimal significant androgenic side effects (Pope & Katz, 1994), including one involving the highly androgenic oral steroid oxymetholone (Hengge, et al.). Androgens also have the capacity to be converted into estrogen by chemical reactions and enzymes within certain body tissues. The process by which the steroid molecule is converted to estrogen is called aromatization. Those anabolics that are easily aromatized into estrogen can cause a feminization of the breast tissue known as gynecomastia. While largely dose related, a natural propensity for this condition can cause it to occur even in moderate dosages. This condition can often be avoided or arrested by the judicious use of anti-estrogenic compounds. Once a serious cosmetic problem exists, minor surgery is required to correct it. Numerous professional bodybuilders have had this surgery (Phillips, p. 125) and others obviously need it (look closely at a very top place finisher in the 1998 Mr. Olympia lineup).
Anabolic Steroids and the Liver
Anabolic steroids are processed by the liver. As discussed earlier, C-17 alkylated oral steroids (steroids with an alkyl group added at the alpha position of the "C-17" or number 17 carbon atom of the molecule to withstand total degradation on their first pass through the liver [see Steroids 101 section above]) are unusually harsh on the liver. For this reason, even moderate short-term administration of these C-17 oral steroids can effect liver function test readings. Elevated liver counts indicating liver stress (toxicity) have been reported in recent studies of somewhat moderate oral anabolic steroid therapy (daily doses of 40 and 80 mg of oxandrolone [Oxandrin, formerly Anavar]) as reported in the online periodical Medibolics, edited by Michael Mooney (www.medibolics.com). However, these elevated liver function readings will return to normal after cessation of a moderate, short-term steroid cycle. I could find not one case to the contrary. Further, it is recognized that intense weight training alone often causes changes in liver function tests, including SGOT, SGPT and LDH (this is something that all physicians monitoring athletes using anabolics should be familiar with).
The more serious liver problems attributed to anabolic steroid use include hepatocellular carcinoma (liver cancer) and peliosis hepatitis (blood-filled sacs within the liver). But the majority of cases reporting liver problems have dealt with extremely sick and elderly patients treated with C-17 alkylated oral steroids for years of continuous use, and many of these patients had a particular type of anemia linked to liver tumors even without anabolic steroid therapy. A computer search of the medical literature looking for steroid-associated liver tumors could find only three in athletes (Friedl, 1990). Of the three athletes, one was using 700 mg of oxymetholone a week for five straight years, and one had a tumor more indicative of classic liver cancer than of steroid-associated tumors. Virtually all of the reported liver problems seemed to occur with the 17 alpha-alkylated oral steroids. There have been no cysts or liver tumors reported in athletes using the 17 beta-esterified injectable steroids (Wright & Cowart, p. 61). It has been noted that injectable steroids generally appear to have little effect on the liver at all (Haupt, 1993, p. 469).
Recent studies continue to suggest that reports of serious adverse effects of anabolic steroids upon the liver in healthy athletes may be highly overstated. In a study of athletes, of the 53 current or past steroid users who underwent laboratory testing, only one subject displayed an abnormal liver test (Pope & Katz, 1994, p. 379; incidentally, on physical examination, not one user displayed evidence of any major abnormalities possibly attributable to steroids, such as high blood pressure, edema, acne or hair loss.) Another study tested one of the most powerful and reputedly dangerously toxic anabolic steroids for 30 weeks on HIV positive men and women (Hengge et al.). Oxymetholone, formerly known as Anadrol in the U.S. and a C-17 alkylated oral steroid, was administered in a dosage of over 1,000 mg per week (more than that used by many bodybuilders, and for a much longer duration of uninterrupted use). The results were significant gains in lean muscle mass -- even without any weightlifting. Even more importantly - and surprisingly -- there were no significant problems with liver function, water retention, or virilization side effects (it will be interesting to see whether further studies yield consistent findings at such high dosages).
While the dangers of anabolics to athletes' livers appear to have been highly exaggerated, it must be recognized that an apparently healthy athlete with a previously existing but undiscovered liver problem could do serious damage to himself by self-administering C-17 oral anabolic steroids. For this reason alone, it would be quite irresponsible for any athlete to use anabolic steroids without having a physician regularly conduct blood tests to monitor liver function.
Anabolic Steroids and the Heart
How cardiac risk might be increased by the use of steroids is a subject of speculation and some controversy. High blood pressure is perhaps "one of the most exaggerated claims" of steroid-related health risks, and remains unconfirmed despite numerous studies (Friedl, 1993, pp. 119-120). Regarding blood lipid levels, oral steroids in particular seem to cause a reduction in HDL (high-density lipoprotein cholesterol) levels in some steroid users. However, changes in the blood lipid levels now appear to begin to recover within about a month after discontinued use, and, in fact, most studies do not report an increase in total cholesterol (Yesalis & Cowart, p. 54).
In examining cardiovascular risks, often cited is a case report by (R.A. McNutt, et al, 1988), concerning a 22-year-old steroid-using weightlifter who experienced a sudden heart attack. While often held out by anti-steroid authorities as the "smoking gun" connecting steroid use to heart attacks, a reading of the actual report reveals that the subject weighed 330 pounds and had a total serum cholesterol of a whopping 596 mg/dl! The fact that so few similar case studies exist may well indicate that the condition of this individual was hardly representative of the majority of athletes who use steroids. (Nonetheless, all strength athletes, including steroid users, should regularly monitor serum cholesterol. Obviously, this poor fellow didn't get his cholesterol to 596 overnight, and it is not reported when he last visited a physician prior to his heart attack. To what extent our nation's criminalization approach to steroids, which discourages steroid-users from seeing doctors, contributed to this result is open to speculation.)
While the question of whether short-term, reversible alterations of these cardiac risk factors are detrimental to long-term cardiac health is "unanswered" at this time (Haupt, p. 469), it has been suggested that some characteristics of steroid-users - intense exercising, low body fat, and avoidance of smoking -- tend to put them in a low-risk group for heart disease (Friedl, 1993, p. 120).
Based on our present information, cardiac risks seem to be primarily related to high dosages in the absence of physician monitoring. Jose Antonio, PhD., a nationally recognized authority on drugs in sports who has written a monthly column for Flex magazine, cites a study examining serious cardiovascular side effects in four weightlifters using "massive amounts" of steroids (Antonio, 1998). While there is little doubt that the health problems of these men were caused by their anabolic steroid abuse, these were clearly mega-dose abusers. "[H]igh dose equals high risk," notes Dr. Antonio, but "low-dose androgens (e.g., 200-600 mg per week for 10 weeks) pose little threat to health."
Anabolic Steroids and the Prostate
A legitimate concern is the potential adverse effect of excessive androgens on the prostate gland. While there is one case report of prostate cancer in a bodybuilder (Roberts & Essenhigh, 1986), no studies have shown an increased risk or incidence of prostatic cancer or hypertrophy with androgen use or indicated that androgens per se predispose to these conditions (Swerdloff & Wang, 1993). Numerous male contraceptive studies using up to 200 mg/week for over a year show no evidence of prostate stimulation. Researchers at the University of Iowa recently examined the prostate effects of the administration for 15 weeks of up to 500 mg/week to healthy men in their twenties and thirties (Cooper, et al., 1998, pp. 441-43). No changes in prostate size or serum prostate specific antigen (PSA) levels were detected either during or up to 25 weeks after the last dose. Further, androgens are not the only or even the main causative factor in prostate cancer, as evinced by a case study in which a chronically testosterone deficient man developed prostate cancer (Boccon, 1991, et al.). Warning: this does not necessarily mean that much higher dosages, especially of highly androgenic compounds, might not adversely effect the prostate, especially in older men. It is not known if athletes who have used steroids for prolonged periods will encounter more prostatic problems as they age (Di Pasquale, 1990, p. 62).
Anabolic Steroids and Aggressive/Psychiatric Symptoms
Enormous media attention has been focused upon the reported adverse psychiatric effects (especially violent behavior) of steroid use. "Roid rage" is the descriptive term for steroid-induced "spontaneous, highly aggressive, out-of-control behavior where the police either were called or should have intervened" (Yesalis & Cowart, p. 60). A few researchers have suggested that psychiatric symptoms including increased aggression are a common side effect of anabolic steroid use. For example, a flawed 1988 study suggested that psychiatric disorders occur with unusual frequency among athletes using anabolics (Pope & Katz, 1988, pp. 487-490). But the conclusions of these researchers have been regarded with skepticism by other experts (see, Lubell, 1989, comments of Dr. James Wright and Dr. Charles Yesalis at 178). "If this phenomenon is real, it is relatively rare (probably less than 1 percent) among steroid users. Even among those affected, the impact of previous mental illness or abuse of other drugs is still unclear" (Yesalis & Cowart, p. 60). "Some long-time steroid users have never suffered any emotional instability, or anything more than transient physical effects" and many steroid users describe non-violent feelings of euphoria, well-being and enhanced self-confidence as common effects (Wright & Cowart, p. 51). In one study to determine the psychiatric effects of steroid use on athletes, no significant differences could be found between users and non-users. "The facts that steroids have been used by tens of thousands if not hundreds of thousands of athletes over two decades and that behavioral effects are only recently being discovered (in small numbers) tend to support [that feelings of aggression may not be observed in the majority of steroid users]. Our findings are compatible with and complementary to those in anecdotal reports and data from individual psychiatrists" (Bahrke, et al., 1990, pp. 834-835). The researchers do not rule out, however, the possibility that in a small minority of predisposed individuals, "steroid use may be sufficient to push them over the edge and contribute to irrational or violent behavior." Many experienced steroid users have found that steroids enhance certain preexisting personality problems. Angry and combative users will become angrier and more combative; however, while normal guys will train more aggressively, they won't generally become violent.
Not surprisingly, when psychiatric problems do occur in study subjects, there seems to be a direct correlation between dosage and prevalence of syndromes. For example, no significant psychiatric effects have been noted where reported mean weekly dosage was 318 mg (heaviest user was 620 mg/wk) (Bahrke, et al., 1992, p. 717). But where reported dosage exceeded 1,000 mg/wk, 11 out of 25 subjects (44%) exhibited mood disorders (Pope & Katz, 1994, p. 380). While, based on this and other studies, there is a dose-related correlation between steroid use and psychiatric effects, it must be noted that not all steroid users exhibit such symptoms; in fact, nearly 90% of light and moderate dosage users in this particular study exhibited no mood disorder symptoms at all.
The psychiatric effect that massive amounts of anabolics might have upon predisposed individuals has created a new defense in criminal cases (see, Lubell). Just as voluntary alcohol intoxication can be used to negate the specific intent required for certain crimes, so has voluntary ingestion of anabolic steroids been offered in the defense of various violent crimes in an effort to prove that the accused was unable to distinguish right from wrong or to understand the consequences of his acts. A sampling of these cases reveals, generally, that such defenses were unsuccessfully raised. This may be due in part to the fact that in many cases the dosages administered were either not specified or were too low to be persuasive. A bigger factor may be the general reluctance of juries to acquit in murder cases based on insanity defenses, especially where the insanity was caused by a voluntarily consumed substance.
Anabolic Steroids and Psychological Dependence
There is some evidence that anabolic steroid use can lead to psychological dependence in certain individuals. Whether the dependence is due to chemical effects upon the brain or simply because of the positive reinforcement occasioned by a more muscular physique is not known. Whatever the cause, this may be the most dangerous aspect of steroid use for those it affects. The cessation of steroid use, especially after a prolonged cycle, often leaves the user in a state of low endogenous testosterone levels. For individuals with an inadequate sense of self, the loss of some portion of the steroid gains can be psychologically devastating to the ego. These individuals can be unable to resist immediately resuming steroid use. Further, as the goal of hardcore bodybuilders is not optimal muscle size, but maximal muscle size, dosages can become excessive. While many athletes successfully use steroids intermittently and with moderation, it is a sobering thought that there are certain individuals who start out on low risk, short-term cycles and ultimately end up using massive dosages for years of uninterrupted use. It might be theorized that the problem of dependence on steroids by certain bodybuilders has less to do with the nature of the substance than with the psychological profile of the users.
Other Adverse Effects of Anabolic Steroids
Connective tissue injuries. The medical literature regarding the suggestion of increased athletic injuries caused by anabolic steroid use is scant (Di Pasquale, August 1992, pp. 12-13). It is not unreasonable to expect muscle and tendon tears in hardcore strength athletes, regardless of steroid use. However, the exceptional frequency and severity (often requiring surgical reattachment) of such injuries in professional level bodybuilders do raise suspicions as to the possibility that steroids, diuretics, or other drugs may be implicated. Former Mr. Olympia Dorian Yates has suffered training-related injuries to the chest, leg and biceps, and retired after a major triceps injury. Pro bodybuilder Alq Gurley reportedly completely tore the quadriceps muscles in both legs when he fell while simply walking! Whether these injuries are steroid-related is as yet unknown, although some animal studies have suggested that steroids may cause tendon degeneration and increased risk of tendon rupture. It may not be unreasonable to assume that, like many adverse steroid effects, connective tissue injuries are mostly associated with high-dose, prolonged usage.
AIDS. Many articles include this as a possible consequence. Quite frankly, anyone who would even consider sharing needles with his gym buddies in this day and age is so irresponsible and judgment-impaired that the substance of this entire article is lost on him.
Premature Closure of Growth Plates. Chronic steroid usage prior to puberty or in early adolescence can cause premature closure of the growth plates of the long bones, preventing the young user from attaining full natural height. For this reason as well as others previously discussed, teenagers should not use steroids for muscle building.
The Dangers of Counterfeit Steroids
One of the primary effects of our government's crackdown on legitimate anabolic steroids has been the expansion of a huge black market of counterfeit products. While estimates vary widely, many authorities assert that the majority of anabolics available on the black market are fakes. These counterfeits are manufactured under unsupervised and potentially unsanitary conditions, and may contain no real androgens at all (see, Di Pasquale, 1995). They may also be contaminated with bacteria or other dangerous substances. Noted steroid expert Dr. Robert Price: "My colleagues at Mount Sinai Hospital in New York tell me they are treating many more athletes for side effects of counterfeit and bogus steroids than they did when reliable pharmacy-purchased steroids were available" (Allen, 1998, p. 224).
If the health dangers of real anabolic steroids have been overstated, the dangers of counterfeit anabolics may be understated. The problem is particularly serious because of how difficult it is to distinguish a real product from a counterfeit knock-off. As an example of these very subtle differences, compare legitimate versus counterfeit Anapolon 50 tablets by Syntex (Grunding & Bachmann, 1996, pp. 349-351, photographs at 357-358, 361).
Conclusion
It can be concluded that "[a]s used by most athletes, the side effects of anabolic steroid use appear to be minimal" (Di Pasquale, 1990, p. 5). Despite over forty years of use by athletes, many of whom are now well into middle-age, we have yet to hear reports of an epidemic of steroid-related deaths. A review of the medical literature does not support the depiction of a serious health crisis related to anabolic steroids. Of course, it would be untrue to say that anabolic steroids, especially black market products, are safe for unsupervised, unmonitored self-administration. On the other hand, it would be equally untrue to say that anabolics are "deadly drugs" deserving of the imposition of harsh criminal penalties for personal use by adults. Accordingly, there is a serious question as to whether Congress may have grossly overreacted in addressing the non-medical use of anabolic steroids by athletes. For further discussion of this issue, and why dispensing steroids should be put back in the hands of trained physicians instead of the black market's dubious "experts," see the section entitled Do Our Anabolic Steroid Laws Work?.
Reference Sources
In addition to the published sources listed below, this writer was assisted by correspondences with authorities in the field. I would like to express appreciation to Dr. Don Catlin, Dr. Mauro Di Pasquale, Michael Mooney and Dr. Charles Yesalis for their time and assistance.
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