Positive and Negative Effects of Steroid Use

[Jinzang]

The abstract is so clear that it's worth quoting the whole thing:

An estimated 4‐6% of fitness center visitors uses anabolic androgenic steroids (AAS). Reliable data about adverse reactions of AAS are scarce. The HAARLEM study aimed to provide insight into the positive and negative effects of AAS use. One hundred men (≥18 years) who intended to start an AAS cycle on short notice were included for follow‐up. Clinic visits took place before (T0), at the end (T1), and three months after the end of the AAS cycle (T2), and one year after the start of the cycle (T3), and comprised a medical history, physical examination, laboratory analysis and psychological questionnaires. During the follow‐up period, four subjects reported a serious adverse event, i.e. congestive heart failure, acute pancreatitis, suicidal ideation and exacerbation of ulcerative colitis. All subjects reported positive side effects during AAS use, mainly increased strength (100%), and every subject reported at least one negative health effect. Most common were fluid retention (56%) and agitation (36%) during the cycle, and decreased libido (58%) after the cycle. Acne and gynecomastia were observed in 28% and 19%. Mean alanine transaminase (ALT) and creatinine increased 18.7 U/l and 4.7 µmol/l, respectively. AAS dose and cycle duration were not associated with the type and severity of side effects. After one year follow‐up (T3), the prevalence of observed effects had returned to baseline. There was no significant change in total scores of questionnaires investigating wellbeing, quality of life and depression. In conclusion, all subjects experienced positive effects during AAS use. Four subjects experienced a serious adverse event. Other side effects were mostly anticipated, mild and transient.

 

[tareload]

The abstract is so clear that it's worth quoting the whole thing:

An estimated 4‐6% of fitness center visitors uses anabolic androgenic steroids (AAS). Reliable data about adverse reactions of AAS are scarce. The HAARLEM study aimed to provide insight into the positive and negative effects of AAS use. One hundred men (≥18 years) who intended to start an AAS cycle on short notice were included for follow‐up. Clinic visits took place before (T0), at the end (T1), and three months after the end of the AAS cycle (T2), and one year after the start of the cycle (T3), and comprised a medical history, physical examination, laboratory analysis and psychological questionnaires. During the follow‐up period, four subjects reported a serious adverse event, i.e. congestive heart failure, acute pancreatitis, suicidal ideation and exacerbation of ulcerative colitis. All subjects reported positive side effects during AAS use, mainly increased strength (100%), and every subject reported at least one negative health effect. Most common were fluid retention (56%) and agitation (36%) during the cycle, and decreased libido (58%) after the cycle. Acne and gynecomastia were observed in 28% and 19%. Mean alanine transaminase (ALT) and creatinine increased 18.7 U/l and 4.7 µmol/l, respectively. AAS dose and cycle duration were not associated with the type and severity of side effects. After one year follow‐up (T3), the prevalence of observed effects had returned to baseline. There was no significant change in total scores of questionnaires investigating wellbeing, quality of life and depression. In conclusion, all subjects experienced positive effects during AAS use. Four subjects experienced a serious adverse event. Other side effects were mostly anticipated, mild and transient.

Thanks for posting. Great news unless you are one of those 4 unfortunate subjects. Or as Mike Tyson is quoted as saying, "Everyone's got a plan until they get punched in the mouth."

Better to leave alone unless you know how you are going to respond, which of course you won't know a priori.

Or graphically, the landscape of Dunning-Krueger which can be applied to most things including your individual response to AAS. Assume your optimal therapeutic dosing of anabolic therapy is quite low:

The Dunning-Kruger Effect | Onlinepethealth Vet Rehab Blog

The Dunning-Kruger effect: a cognitive bias that states that the less we know, the more confident we are. The Dunning Kruger effect is a well-known bias that explains the relationship between confidence and knowledge. I hope you learn as much from this as I have.

onlinepethealth-info.com

 

[tareload]

Some other thoughts, let's say you like that first "cycle", what about another one?

Long Term Effects of 500mg Test/Week and What is "Long"?

Thanks @blshaw Hello @yeahbuddy27 Is this a question to help you feel better/rationalize about the use of supraphysiologic dosages of testosterone for years, or is the question a genuine interest in what the pathological consequences will be in 1, 5, 10, 20 years? Just curious. It is a roll...

forums.t-nation.com

Big difference using these powerful hormones in a life or death (therapeutic sense) vs a healthy individual doing this voluntarily for usual vanity reasons.

I remain thankful and grateful everyday for persons like @Nelson Vergel who have devoted a large portion of their life studying and providing outreach in this area for folks who really need the therapy. Even then, it's not always a slam dunk (I can attest). Thank you Nelson for your work and sacrifice.

 

[Nelson Vergel]

Thanks for your kind words, @readalot

I really think any educated consumer should have the right to use them, though. The key is educating themselves to monitor and minimize side effects (just like TRT).

 

[tareload]

I really think any educated consumer should have the right to use them, though. The key is educating themselves to monitor and minimize side effects (just like TRT).

Great point. Sort of a driver's license type training for AAS. I can see the final exam where the applicant has to explain the importance of Hct, CNS upregulation, liver enzymes, and periodic echos and EKGs. You got me!

 

[madman]

Study limitations

Several limitations of the HAARLEM study are described elsewhere and include the exclusion of athletes who use AAS continuously and the introduction of selection bias by offering medical check-ups for free. Moreover, AAS cycles were greatly heterogeneous and, as mentioned, the calculation of androgen dose was unreliable. Multivariable analysis cannot fully adjust for confounding factors and unmeasured or unknown confounders were not taken into account.

Furthermore, only one clinic visit took place during the AAS cycle. They used questionnaires to reflect on the past one or two weeks and psychological changes that occurred earlier in the cycle may have been missed. Some recall bias may still have led to underreporting of certain side effects, but was minimized by using checklists during clinic visits. Also, the questionnaires are not validated and may not be sensitive to detect effects typically resulting from androgen exposure. Another shortcoming is that the severity of the self-reported side effects was not recorded systematically. However, only 13% of subjects considered side effects severe enough to stop or adjust the intended AAS cycle. Obviously, the results of this study do not exclude potential long term side effects of androgen abuse. The design of the study also precludes convincing statements about the causality of the rare but serious adverse effects that were encountered.





PERSPECTIVE

The HAARLEM study provides a detailed and reliable overview of the side effects of AAS use in a prospectively analyzed and representative cohort of 100 amateur male athletes during a one-year follow-up. All users experience positive side effects such as an increase in muscle strength and size. All users encountered negative side effects as well, most prominently gynecomastia and acne, but these were usually anticipated, mild, and transient. Acute or subacute effects on liver and kidney function were absent or completely reversible and unrelated to the use of oral androgens. In the vast majority of users, androgen exposure and withdrawal will not lead to clinically relevant psychological effects. In a few subjects, a serious adverse event occurred. Cycle dose and duration cannot be used to predict the chance to suffer side effects, nor its severity. For most users, the benefits of AAS use outweighed the side effects, supported by the observation that side effects rarely led to the termination of AAS use. Solely informing AAS users about side effects will probably not be effective in preventing athletes from using AAS. Future studies should therefore focus on the long-term health risks of AAS use and on how to reduce harm in athletes using AAS.

 

[madman]

Most AAS users/abusers are well aware of the chance of experiencing cosmetic side-effects during use such as water retention, stretch marks, acne (genetically prone), MPB (genetically prone), increased body hair growth, gynecomastia (genetically prone), along with possible negative effects on lipids (HDL/LDL), blood pressure, increased RBCs/hemoglobin/hematocrit, testicular atrophy, impaired fertility, shut-down of the hpta.

Most of these side-effects are temporary and reversible once AAS use is ceased other than hair loss, body hair growth, stretch marks, gyno (depending on severity as surgery may be needed), and more importantly dysfunction of the hpta which in some cases may be permanent with long-term abuse.

Even then many of these side-effects can be minimized/managed with the use of ancillaries during/post-cycle.

Most are willing to endure such effects for the sole purpose of the well-known effects on increased muscle mass/strength.

What is concerning are the possible long-term effects on the cardiovascular system and brain (neurotoxic) let alone damage to the hpta.

Unfortunately many dabbling in the chemical enhancement game start in their prime (teens/the early 20s).

 

[Jinzang]

Three confounding factors that make it difficult to assess the long term effects of steroid use are that steroid users are more likely to engage in other risky behaviors, they are more likely to use other drugs such as GH, insulin, and clenbuterol, and steroid users eat a diet much different than typical non-steroid users.