Understanding the trade-off you may be making if the anabolic steroid route looks attractive.
There’s a lot of attention around anabolic steroids and the people that use them.
This attention usually exemplifies the muscle-building and physique-enhancing effects (which is what they’re able to assist with very well). It doesn’t always bring much attention to what else is going on and the numerous potential adverse health effects that taking high amounts of anabolic steroids can create.
It may look like an attractive opportunity to quickly get the body you want and look like your favourite ‘fitness influencer’ or movie star.
It’s important to understand what you could be getting yourself into, and consider the trade-off you may be making.
There’s more to it then ‘roid rage’ and smaller balls.
Let’s have a look ...
Inside our bodies we all create a certain amount of androgens (sex hormones) that play a role in growth and reproduction (the most well-known is testosterone).
Anabolic steroids are essentially synthetic versions of testosterone.
These can be used in controlled amounts for medical reasons, or they can be abused by people looking to drastically increase muscle mass, strength gain and performance enhancement.
When injected, swallowed (pill form), and/or rubbed on the skin (gels, creams), anabolic steroids enter circulation and interact with ‘androgen receptors’ which are found in different parts of the body.
When it comes to the well-known effect of muscle mass gain, strength gain and performance enhancement, this is the result of anabolic steroids shifting the bodily processes towards growth (protein synthesis) and away from protein breakdown at these tissues.
Now, because ‘androgen receptors’ (which steroids interact with) are found in different parts of the body, and not only in your muscles, there are other effects which can take place in other organs, tissues and bodily functions (eg. liver/kidneys, skin, reproductive organs, nervous system). (1)
- Increased chance of serious muscle injuries (could be to do with poor re-building of the tissue and less growth of blood vessels that nourish the muscle) (2)
- Can lead to unhealthy tendons (eg. they can become stiffer and don’t adapt the way they should from training etc) that are more prone to injury and rupture (3)
- Lesser quality and functioning muscles: Dr Keith Baar (“muscle mass on health” podcast episode) uses a great analogy of a drain to explain how anabolic steroids affect your muscular system. He explains that we need a ‘clear drain’ that allows the breakdown of our muscles (an important process in rebuilding healthy muscles). Steroids essentially ‘plug the drain’ and create ‘lots of junk in the sink’, not allowing this breakdown (which is good for increasing size) and thus leading to muscles that don’t function as well and aren’t as healthy.
One big reason for training is to reduce our chances of injury. By taking high amounts of anabolic steroids, you’re negating these benefits and are instead paving the way to potential injury.
Another trade-off: You’re getting bigger muscles, but you’re potentially damaging your brain.
- High doses of anabolic steroids can negatively effect your brain cells (neurotoxic). (2)
- There are some really beneficial processes that occur during physical activity that assist with brain health – anabolic steroids can impair these beneficial effects. (2)
- A study looked at weightlifters exposed to anabolic steroids. They found negative physical changes within the brain of users compared to non-users (such as reduced volume in certain areas of the brain). Their cognitive functions were lower. (2) (4)
- Another study that looked at the same group of participants as above, found accelerated brain ageing and older-appearing brains in long-term users. (4)
You’re probably aware of the potential for ‘roid rage’ (increased aggressiveness). Because high dose anabolic steroids can affect your neurotransmitters/nervous system, there’s also evidence of:
- Anxiety, depression and memory impairment (2).
It’s hard to get a clear cause-and-effect when discussing something like behaviour, but these associations do exist, and the fact that anabolic steroids can influence your brain, neurotransmitters and central nervous system, they are most likely affecting behaviour.
This one’s a big one and tends to be the most susceptible to damage.
There’s evidence of increased plaque in arteries, decreased HDL and increased LDL cholesterol levels (unfavourable changes), impaired function of your blood vessels, blood pressure increases, damage and inflammation in parts of the heart, and an inability for parts of the heart to function as well as they should (such as your left ventricle). (2) (5) (6)
The liver takes a beating as it’s one of the main places that steroids are cleared. High dosages of anabolic steroids are toxic and can lead to a number of different forms of liver injury (such as tumours and lesions in the liver). (7)
There are studies that show a ‘direct toxic effect on kidneys’ and cell growth/enlargement of areas of the kidney. (2)
There is a correlation between the abuse of anabolic steroids and cancer. There are a number of different pathways which may create carcinogenic compounds, create cell proliferation, lead to DNA damage and so on. (2)
Because testosterone makes such a big contribution to your reproductive system, when you introduce the synthetic version in levels you’re not able to produce naturally, it can have far-reaching negative effects.
A paper by Christou et al., 2017 looked at 33 quality studies to see how anabolic steroids impact the reproductive system of athletes and recreational users. They concluded that:
- If you stop using them, some hormone levels return to normal, but your natural testosterone levels stay lower. (8)
- When it comes to the long term effects for men, these include smaller testes (testicular atrophy), an increase in breast tissue (gynecomastia), and reduced fertility (sperm changes). (8)
- For women, there are menstrual irregularities and an enlargement of the clitoris. (8)
- With long periods of testes and ovaries not functioning the way they should (due to anabolic steroid use), this can lead to negative effects on mood and memory, sex drive, fatigue, bone density and heart health. (8)
That’s a lot of negative effects among many different parts of the body.
Now, this doesn’t necessarily mean they will all occur, a lot of these papers were talking about prolonged abuse, but some of these effects still occur on a short term basis too.
It’s important to look at it as a trade-off.
Professional athletes/bodybuilders who get paid the big bucks may make this trade-off. But for the general population, you’re opening the door to a huge number of potential side effects – all for having some more muscle?
There are many reasons we should be participating in physical activity; anabolic steroid use negates the majority of these reasons and enhances just one (muscle gain). Does it sound like it’s worth it?
Anabolic steroids have an important role in medical settings where they are used to treat hormone issues, serious conditions such as bone marrow failure and aplastic anaemia, and can help patients who have muscle wasting, depression or fatigue from HIV or another immunodeficiency syndrome. (7)
There are also treatments such as testosterone replacement therapy which, under the careful eye of a doctor, can restore an individual’s hormone levels to ‘good’ levels (levels that were once achievable naturally) and can have many potential benefits on someone’s quality of life (body composition, mood, sexual function etc.).
Having ‘optimal’ levels of testosterone does a lot of good for both males and females. When it comes to optimising these levels, it should centre around prioritising and improving health behaviours such as:
The physique-enhancing effects of anabolic steroids can be glorified and may seem attractive for those who want a more muscular physique in a short period of time. There’s also the increasing normalising of it’s use within the fitness industry, yet the same attention isn’t always given to the potential side-effects.
It’s important to understand the trade-off you may be making and how it can negatively affect different organs, tissues, behaviours and bodily functions. This is what I hoped to achieve with this blog post.
If you want to enjoy the physique- and performance-enhancing effects of anabolic steroids, your best bet is optimising your own natural levels through healthy behaviours. That way, you get to reap the benefits of physical activity for your health, you don’t have to worry about potential side-effects that can derail your life and, over time, you end up building an impressive physique anyway.
3. Guzzoni, Vinicius et al. “Tendon Remodeling in Response to Resistance Training, Anabolic Androgenic Steroids and Aging.” Cells vol. 7,12 251. 7 Dec. 2018, doi:10.3390/cells7120251
4. Bjørnebekk, Astrid, et al. “Long-Term Anabolic–Androgenic Steroid Use Is Associated with Deviant Brain Aging.” Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, vol. 6, no. 5, 2021, pp. 579–589., doi:10.1016/j.bpsc.2021.01.001.
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