Anabolic Testosterone Tablets
Dallas Querry
Anabolic steroids are synthetic (man-made) versions of testosterone. Testosterone is the main sex hormone in men. It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Women do have some testosterone in their bodies, but in much smaller amounts.
Some bodybuilders and athletes use anabolic steroids to build muscles and improve athletic performance. They may take the steroids orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses used to treat medical conditions. Using them this way, without a prescription from a health care provider, is not legal or safe.
Most serious athletes feel a strong drive to win. They often dream big too. Some athletes want to play for professional sports teams. Others want to win medals for their countries. The pressure to win leads some athletes to use drugs that might give them an edge. These are called performance-enhancing drugs. Use of these drugs is known as doping.
Anabolic steroids are drugs that athletes take to boost their strength and add muscle. These drugs also are called anabolic-androgenic steroids. They are made to work like a hormone that the body makes called testosterone.
What makes some athletes want to use anabolic steroids? These drugs might lower the damage that happens to muscles during a hard workout. That could help athletes bounce back faster from a workout. They might be able to exercise harder and more often. Some people also may like how their muscles look when they take these drugs.
More-dangerous types of anabolic steroids are called designer steroids. Some drug tests may not be able to spot them in a person's body. Anabolic steroids have no medical use that's approved by the government.
Many athletes take anabolic steroids at doses that are too high. These doses are much higher than those that health care providers use for medical reasons. Anabolic steroids have serious side effects too.
Doping with anabolic steroids is banned by most sports leagues and groups. And it is not legal. It's never safe to buy anabolic steroids from a drug dealer. The drugs could be tainted or labeled the wrong way.
Andro can be made in a lab. Some drugmakers and workout magazines claim that andro products help athletes train harder and recover faster. But some studies show that andro doesn't boost testosterone. They also show that muscles don't get stronger.
Andro can damage the heart and blood vessels in anyone who takes it. This raises the risk of a serious problem that can happen when the heart doesn't get enough blood, called a heart attack. It also raises the risk of a condition that keeps the brain from getting enough oxygen, called a stroke. Heart attack and stroke can be deadly.
Athletes take human growth hormone, also called somatotropin, to build more muscle and do better at their sports. But studies don't clearly prove that human growth hormone boosts strength or helps people exercise longer.
Erythropoietin is a type of hormone. It treats anemia in people with severe kidney disease. It raises the level of red blood cells. It also raises the levels of the protein in red blood cells that carries oxygen to the body's organs, called hemoglobin.
In the 1990s, it was common for pro cyclists to use erythropoietin. But the drug may have played a role in at least 18 deaths. Doping with erythropoietin may raise the risk of serious health problems. These include stroke, heart attack and blocked arteries in the lung.
Diuretics are drugs that change the body's balance of fluids and salts. They can cause the body to lose water, which can lower an athlete's weight. Diuretics also may help athletes pass drug tests that check for signs of drugs in the urine. They dilute the urine and may hide traces of drugs.
Nutrients are vitamins and minerals in foods that are good for you. Some people try to get more nutrients from products called supplements. Supplements are sold in stores and online as powders or pills. One supplement that's popular with athletes is called creatine monohydrate.
Creatine seems to help muscles make more of an energy source called adenosine triphosphate (ATP). ATP stores and moves energy in the body's cells. It's used for activity that involves quick bursts of movement, such as weightlifting or sprinting. But there's no proof that creatine helps you do better at sports that make you breathe at a higher rate and raise your heart rate, called aerobic sports.
Some athletes try to gain weight so they can get bigger in size. Creatine may help you put on weight over time. But that might be due to the extra water that creatine causes the body to hold on to. Water is drawn into muscle tissue, away from other parts of the body. That puts you at risk of getting dehydrated.
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Androgenic steroids are used for male sex hormone replacement and in the therapy of malignancies. The androgens also have anabolic effects and are used in catabolic or muscle wasting states. In addition, the synthetic anabolic steroids are now widely used illicitly for exercise and athletic performance enhancement. Many synthetic androgenic steroids are capable of causing cholestatic liver injury and long term use of androgens is associated with development of liver tumors including hepatocellular carcinoma, hepatic adenoma and vascular changes (peliosis hepatis).
Use of androgenic steroids is associated with a variable rate of serum enzyme elevations which are usually asymptomatic and self-limited. Such elevations have been most closely linked to danazol and oxymetholone, but are usually transient and do not require dose adjustment or discontinuation.
Use of anabolic steroids has also been linked to vascular changes in the liver referred to as peliosis hepatis. Peliosis hepatis is a rare syndrome in which there are blood filled enlarged sinusoids and cysts focally or throughout the liver. There is usually an accompanying sinusoidal dilatation and loss of the normal endothelial barrier. The liver may be enlarged, deep red in color and fragile. Peliosis hepatis most typically occurs in patients with advanced wasting diseases (tuberculosis, cancer), but has also been associated with long term use of anabolic steroid therapy for aplastic anemia and hypogonadism as well as in body building. Serum enzyme levels are usually normal or are mildly and nonspecifically elevated. Patients may present with right upper quadrant discomfort and hepatomegaly or with sudden abdominal pain and vascular collapse due to hepatic rupture and hemoperitoneum. Peliosis may also be an incidental finding found on imaging of the liver or during abdominal surgery or at autopsy. Peliosis associated with anabolic steroids usually reverses, at least in part, with stopping therapy. Peliosis can involve other organs, most typically the spleen.
The androgens act by engagement of intracellular androgenic steroid receptors which are translocated to the nucleus and bind to androgen response elements on DNA inducing a cassette of androgen stimulated genes that are important in cell growth and development. An unregulated growth stimulus to hepatocytes is the likely cause of nodular regeneration and hepatic tumors related to anabolic steroid use. The cause of cholestasis due to the C-17 substituted androgens is not well defined, but high doses cause a similar cholestasis in some animal models. The syndrome is similar to cholestasis of pregnancy and the jaundice associated with high doses of estrogens or birth control pills and may be due to partial lack or variant of bile salt transporter proteins, as reported in some patients with androgenic anabolic steroid associated cholestasis.
The severity of liver injury due to anabolic steroids ranges from minor, transient serum enzyme elevations to profound and prolonged cholestasis, as well as hepatic peliosis and benign and malignant liver tumors. The first priority in management should be stopping the androgenic steroid. Unfortunately, athletes and body builders may resist this recommendation. Merely decreasing the dose of androgenic steroid or switching to another formulation is not appropriate and should be specifically discouraged. Patients being treated for hypogonadism may be switched to an unmodified form of testosterone, given by injection or cutaneous patch. Patients with marked cholestasis may be benefitted by symptomatic therapy of pruritus and fat soluble vitamin supplementation. Ursodiol is often used in drug induced cholestasis, but is efficacy has never been shown in a controlled prospective manner. Use of corticosteroids is usually ineffective and should be avoided. The syndrome is usually reversable with stopping therapy, but full recovery is often delayed. In addition, fatalities have been reported, usually due to marked cholestasis complicated by malnutrition, renal failure and associated opportunistic infections.
Representative androgenic steroids include the following: danazol, fluoxymesterone, methandienone, methenolone, methyltestosterone, nandrolone, norethandrolone, oxandrolone, oxymetholone, stanozolol, testosterone (cypionate, enanthate, propionate).
A 24 year old body builder developed pruritus and jaundice having taken various anabolic steroids for one and a half years. He was also taking several herbal products and dietary supplements including Ma Huang (6% ephedrine), carnitine and chromium. He also drank alcohol, estimating his average intake as one case of beer per day for the last year. He developed dark urine and jaundice and stopped all medications and his alcohol intake promptly. Despite this, he remained jaundiced for a month and had worsening nausea and weight loss and eventually sought medical care. He had no history of liver disease or risk factors for viral hepatitis and took no other medications. On examination, he was muscular and physically fit but deeply jaundiced. He had an enlarged liver but no rash, fever or splenomegaly. Laboratory testing showed a total serum bilirubin of 53 mg/dL, but only modest elevations in serum aminotransferase and a normal alkaline phosphatase level (Table). His prothrombin time was normal. Tests for hepatitis A, B and C were negative. Abdominal ultrasound showed no evidence of biliary obstruction. Liver biopsy was not done. He was treated symptomatically for pruritus with antihistamines, cholestyramine and ursodiol. His jaundice gradually improved and pruritus waned. Six months after the onset of jaundice, he was asymptomatic, had regained most of his weight loss (40 pounds), serum bilirubin was 1.5 mg/dL and serum enzymes were normal.
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