Anabolic Steroids react on the body in four primary ways.

Anabolic steroids when combined with resistance training and a diet high in calories -- specifically protein, cause an increase in protein synthesis which in turn provides protein molecules used by the body to increase the size and strength of the skeletal muscle cell -- skeletal muscles being the major muscles of the body. The obvious goal of the bodybuilder is muscular hypertrophy or growth and anabolic steroids can accelerate this process. To maintain this hypertrophy, periodic stimulation (weight lifting) of the muscle is necessary. Without this stimulation, the protein synthesis process will reverse and the skeletal muscle will atrophy.

The cycle of protein in the body is constantly changing. The body is in a continual cycle of anabolism (muscle building) vs. catabolism (muscle breakdown). Anabolic steroids alter this cycle and prevent to a certain degree the catabolic phase and may actually bind to the cortisone receptors of cells preventing the highly catabolic hormone cortisol from binding to muscle cells and releasing protein. Methandrostenolone has a dramatic effect on cortisol; perhaps this is one reason for its tremendous efficacy. This cortisol binding inhibition, makes resistance training more effective as the muscle is now only growing. Reacting on the receptor sites of a muscle cell -- anabolic steroids promote nitrogen retention by the muscle. Nitrogen is a component of protein. When more nitrogen is retained than released, a muscle is said to be in a positive nitrogen balance state. A positive nitrogen balance equals muscle growth.

Anabolic steroids therapy in athletes increases the production of a nitrogenous compound called Creatine Phosphate (CP). CP promotes the storage of certain enzymes in a muscle cell including ATP (Adenosine Triphosphate). ATP is used by the body for muscle contractions. This enzyme breaks down to ADP (Adenosine Diphosphate) which is the fuel used to make muscles move. As more Creatine Phosphate is available, the conversion of ATP to ADP is enhanced meaning that strength will increase. Incidentally, this is the effect that is thought to be facilitated through creatine monohydrate supplementation -- making this a supplement of significant interest as of late. Oxandrolone, an oral anabolic steroid, is thought to significantly increase CP production by the muscle. This is likely the reason many athletes find Anavar to increase strength even when mass may not increase (60).

Anabolic steroids lead to an increase in the body’s actual blood volume. Two to three weeks into a steroid cycle, blood volume increases by 10% to 20%. Athletes who have used steroids, refer to this as the "steroid pump" or a condition that develops during resistance training whereby, a muscle develops a much larger, more vascular appearance. This "steroid pump" is actually a side effect of the increase in blood volume specifically the red blood cells -- the oxygen carrying component of blood. The increase leads to greater blood flow to the working muscles during training periods. Besides the obvious desirable appearance of an enlarged muscle, the muscle becomes stronger as well. Obviously, this increases training intensity and is a stimulus for new growth. The second benefit to athletes relates to oxygen efficiency with increased RBC (red blood cell) volume. This reported increase in blood volume is the major benefit of steroids to endurance athletes. After the steroid therapy is discontinued, extra plasma volume returns to the normal level, leaving behind an increased RBC count. This increased hemoglobin concentration can increase maximum aerobic capacity. A similar beneficial effect can be achieved through a process known as blood doping. Blood doping involves the reinfusion of blood into an athlete prior to athletic competition. An athletes blood is removed, cooled to increase oxagenation, and then injected back into the athlete (6).

Steroids themselves, possess both anabolic and androgenic properties. Anabolic means the steroids will promote the building of tissue or muscle. Androgenic means that steroids will promote the secondary male sex characteristics. These characteristics are the ones that are primarily affected during adolescence. They include: growth of body hair, growth of facial hair, male pattern baldness, the deepening of the voice, increased production of oil on the skin by the sebaceous glands, development of the penis, sexual behavior, and maturation of the sperm. Primarily the androgenic effects of steroids are the ones that athletes do not want. We do not want the development of male pattern baldness, or increased body hair. The search has been on since the 1960’s to develop a steroid that is 100% anabolic and 0% androgenic. Unfortunately, such a product has not been invented. Steroids range from highly anabolic / low androgenic to highly anabolic / highly androgenic to low anabolic / highly androgenic. The later type of steroids would certainly want to be avoided and lengthy descriptions of such steroids have largely been excluded from this report.

The other negative effect of anabolic steroids relates to steroid toxicity. Toxic steroids are primarily the oral ones and are subject to processing by the liver. This liver processing is harsh and is best avoided. When making the personal decision to use anabolic steroids, one would want to pay special attention to the better steroids which are low in androgenic properties and low in toxic properties. This consideration greatly reduces the side effects that could potentially be experienced on a steroid cycle.