The Good And Bad Of Steroids

By Jeff Cersonsky, MD, FAAP

“I’m concerned that my son, who is an athlete, will be tempted to use steroids. What facts can I give him that will convince him to stay far away from these drugs?”

The compounds we call steroids are based on essential ingredients in our bodies that allow us to control our salt usage and wastage, regulate our growth, and govern our progress through puberty, pregnancy, and other sexual functions. Everyone, even newborns, has steroids in their systems all the time and couldn’t live without them. In fact, there are life-threatening syndromes where steroids are not present in sufficient degree, and we need to replace these normal steroids.

However, what is good in the right amounts can be devastatingly bad when given either in excess, or for the wrong reasons. People discovered that certain steroids that are similar to the male hormone testosterone, called anabolic steroids (whose only legitimate uses are for very rare disorders), helped increase muscle mass and strength. Athletes sought out these compounds, not realizing the potential they have to cause severe adverse effects, and even death. This article will deal with the misuse of dangerous steroids.

Teenagers need to have the facts, rather than scare tactics, in order to make the correct decision not to use anabolic steroids. The pressure is so great on them to perform well, and to exceed their natural capabilities, that steroids may appear to be a tempting quick fix that will get them ahead in their sport in high school or college, or let them consider becoming professionals. They see athletes, such as the baseball players currently under suspicion for steroid usage, and all they see are record breakers rather than walking health time bombs.

From the American Academy of Pediatrics website, here are the facts as to what anabolic steroids can cause when taken for nonmedical reasons:

1. (In everyone) High blood pressure and heart disease; liver damage and liver cancers; stroke; brain tumors and blood clots; urinary and bowel problems, such as diarrhea; headaches; aching joints and muscle cramps; nausea and vomiting; sleep problems; increased risk of ligament and tendon injuries; severe acne, especially on face and back; and baldness.

2. (In males) Reduced sperm count; impotence; increase in nipple and breast size (gynecomastia); and enlarged prostate (gland that mixes fluid with sperm to form semen).

3. (In females) Reduced breast size; enlarged clitoris (a very sensitive part of the genitals); increase in facial and body hair; deepened voice; and menstrual problems.

4. (Psychological effects, in everyone) “Roid rage” — severe, aggressive behavior that may result in violence, such as fighting or destroying property; severe mood swings; hallucinations — seeing or hearing things that are not really there; paranoia — extreme feelings of mistrust and fear; anxiety and panic attacks; depression and thoughts of suicide; and angry, hostile, or irritable moods.

Facts are pretty scary stuff, without making up stories. I had a favorite athlete when I was growing up by the name of Lyle Alzado, who was a ferocious tackler on the Denver Broncos and quite a humanitarian. Years later, he admitted to using anabolic steroids and attributed their use as the cause of the brain tumor that eventually killed him.

Here is a word about two other performance-enhancing drugs. Androstenedione (“Andro”), purchased through many gyms and health clubs, is in reality an anabolic steroid. It potentially carries all the risks of other anabolic steroids and should never have been classified separately by the FDA.

Creatine, a drug that has been touted to increase muscle mass and endurance (but never proven to do so) is not a steroid. Used as a supplement, however, creatine can cause “kidney overload,” dehydration, muscle cramps, and stomach cramps. Be careful, as many sports drinks contain creatine and frequently caffeine. Read the labels on these drinks very carefully.

“My son was advised at the gym where he works out to take an all-natural supplement to help him build muscle. Are these safe?”

Be very careful about such supplements. “All-natural” frequently just means that the supplement can be marketed as a food and not a drug, and therefore has not gone through the stringent testing that drugs must go through. My nephew brought home such a supplement and showed it to me. It contained (all-natural) ground up bull adrenal gland. The adrenal gland is where many of the steroids in the animal are made. This supplement probably contained a high quantity of anabolic steroids. Check the ingredients of any such supplement. Remember that the best way to build muscle is through a supervised exercise program and good nutrition.

Steroids can be very useful to treat disorders, from eczema to cancer. In my next installment, I’ll explore the beneficial uses of prescribed steroids.