Anabolic steroid misuse
Anabolic steroids are synthetic relatives of testosterone. In medicine they have a narrow set of uses; outside medicine they are taken for muscle mass and…
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Medicines commonly prescribed for Anabolic steroid misuse
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 38 MICROGRAMSActive substance: levothyroxine sodiumManufacturer: Merck S.L.Prescription requiredDosage form: TABLET, 75 mcg levothyroxine sodiumActive substance: levothyroxine sodiumManufacturer: Merck S.L.Prescription requiredDosage form: INJECTABLE, Testosterone Cypionate 100 mgActive substance: testosteroneManufacturer: Desma Laboratorio Farmaceutico S.L.Prescription required
Anabolic steroids are synthetic relatives of testosterone. In medicine they have a narrow set of uses; outside medicine they are taken for muscle mass and sporting performance, in doses no doctor would prescribe. The doses are exactly what creates the problem: the body rebuilds itself in places nobody asked it to, and some of that rebuilding cannot be undone. The harm does not arrive at once but after months and years, by which time the result in the mirror has already been achieved and stopping is hard.
What they are not
They get confused endlessly with corticosteroids — the creams for a rash, the asthma inhaler, the tablets for an autoimmune flare. Those are different substances with different effects and nothing to do with building muscle; the word «steroid» is shared only because of the chemical skeleton.
Anabolic steroids do have legitimate uses: a genuine shortage of a man's own testosterone, delayed puberty, some forms of anaemia and severe wasting. There the point is restoring a normal level. The rules on supply differ from country to country, but almost everywhere they are prescription medicines; in sport they are banned and form part of routine doping control.
Why people start
The obvious reason is to build muscle faster and lose fat along the way. Steroids genuinely do this, so arguing about whether they work leads nowhere: the argument is about the price.
The second reason gets said out loud far less often. Some people arrive at steroids not from sport but from a deep dissatisfaction with their own body: they feel they are not big enough, they study themselves for long stretches, avoid changing rooms and beaches, train through injuries. That sits closer to a disorder of how appearance is perceived than to a sporting hobby, and no drug treats it — however much mass is added, the sense of falling short comes back. What works there is help from a psychotherapist.
One more thing, plainly: the belief that a course of steroids makes someone «fit and healthy» is wrong. The visible result and the state of the arteries, the liver and the hormonal system diverge in precisely that direction.
Cycling, stacking and pyramiding
People who use steroids usually know about the risks and build schedules meant to protect them: runs with breaks in between, several products at once, dose climbing to a peak and coming down again. Extra substances are often added as cover — against breast tissue growth, or to restart the body's own hormones afterwards.
There is no evidence that any of these schedules reduces harm. What is known is something else: the higher the total dose and the longer the history, the worse the consequences, and combining products multiplies the load instead of dividing it. Add the quality of the goods: what is sold outside pharmacies often fails to match its label in content, in dose or in purity.
What changes in the body
The body receives the hormone from outside and switches off its own production. Hence, in men, shrinking testicles, a falling sperm count and infertility; part of the testosterone converts into female hormones, so breast tissue grows. Add severe acne on the back and shoulders, male-pattern hair loss, an enlarged prostate with worse urinary flow. Fertility usually returns some months after stopping, but not in everyone.
In women the changes run in the male direction: hair on the face and body, a deeper voice, an enlarged clitoris, smaller breasts, disrupted or absent periods, thinning hair on the head. The deeper voice and the enlarged clitoris often stay for good, long after the drug has been abandoned.
In teenagers there is a separate danger. Steroids speed up the closing of the growth plates in the bones, and if a course falls at an age when growth is unfinished, final height ends up below what it should have been. That cannot be reversed.
The dangerous part: heart, blood, liver
This, and not the changes in appearance, is where the cases that end badly are found.
- Heart. The wall of the left ventricle thickens and the heart relaxes and fills less well. Cardiomyopathy develops and rhythm disturbances appear. Sudden deaths from arrhythmia have been described in young, outwardly healthy people using steroids.
- Arteries. «Good» cholesterol drops sharply, «bad» cholesterol rises, blood pressure goes up. Atherosclerosis arrives decades ahead of schedule, and with it heart attacks and strokes at an age where nobody expects them.
- Blood. It thickens through an excess of red cells, raising the risk of clots — in the legs, in the lungs, in the brain.
- Liver. It suffers most from the tablet forms: jaundice with itching, rising enzymes and, rarely, blood-filled cavities in the liver tissue and benign tumours. Rupture of such a cavity causes internal bleeding and is an immediate threat to life.
- Kidneys. Years of high doses can leave irreversible damage to the filtering apparatus.
- Tendons. Muscle gains strength faster than tendon can toughen, which is why ruptures happen during an ordinary training session.
Mood, sleep and thinking
At high doses the temperament shifts: irritability and flares of anger over trivia, a sense of invulnerability, risk-taking, swings of mood, suspicion of others. Occasionally it reaches delusions and hallucinations, and that needs urgent help. Sleep becomes short and broken, which sharpens everything above.
Injections and what comes with them
Most of these products are injected into muscle, which brings risks that have nothing to do with the substance itself: abscesses and lumps at the injection site, nerve damage and, where a needle or syringe is shared, hepatitis B, hepatitis C and HIV. These infections pass on a minute amount of blood, so «I borrowed a needle once» is a full risk, not a detail.
Dependence, withdrawal and getting out
Dependence on anabolic steroids is real and behaves like any other: craving, needing more for the same effect, carrying on despite obvious harm, feeling wretched when it stops.
After an abrupt stop the body's own hormones do not switch back on straight away — sometimes it takes months. That period brings low mood and apathy, anxiety, insomnia, poor appetite, reduced sex drive, heavy fatigue, headaches, muscle and joint pain, and a fast loss of the mass that was gained. The low mood is the most dangerous item on that list: it can be deep and can lead to thoughts of suicide.
This is why stopping is better done with support. A doctor can assess what has already changed — heart, lipids, liver, hormones, blood count — and follow the recovery rather than guess at it. Help is organised as it is for other dependencies: going through the situation, planning the withdrawal, working on what pulls a person back, and staying alongside through the first months. It is also worth consulting even if you do not intend to stop yet.
When to get help immediately
- pain or pressure in the chest, sudden breathlessness, fainting, a fast irregular heartbeat;
- weakness in an arm or leg, a drooping face, slurred speech;
- pain and swelling in one leg, sudden breathlessness with pain on breathing in;
- severe pain under the right ribs or in the abdomen, yellow skin and eyes, dark urine;
- thoughts of harming yourself.
Online consultation
In an online consultation steroids can be discussed directly: the doctor needs facts, not a confession. They will go through what you take and for how long, judge which tests are needed first, explain what a safe withdrawal looks like, and point you to the right professional to see in person.
This material is for information only and does not replace medical advice.
Consult with a doctor about Anabolic steroid misuse
Discuss your symptoms and possible next steps with a doctor online.
Online doctors for Anabolic steroid misuse
Discuss your symptoms and possible next steps for Anabolic steroid misuse with a doctor online.
