Anabolic Androgenic Steroids

Question 1

When were steroids first used?

Answer 1

• Early major documented use in the 1953 Olympics (weightlifting). Androgenic side effects an issue.
• Used widely by 1969.

Question 2

What are the effects of anabolic androgenic steroids?

Answer 2

• Anabolic - increase muscle size, mass and strength
• Androgenic - masculinising properties
• Used therapeutically for amnesia, thrombosis and to build muscle for the bed-ridden.

Question 3

What did Bhasin et al (2001) find?

Answer 3

That steroids (testosterone injections) increased muscle strength and volume in men in a matched-pairs design.

Question 4

What do all anabolic steroids contain?

Answer 4

Testosterone or testosterone derivatives.

Question 5

How can steroids be administered?

Answer 5

Orally or by injection (intramuscular).

Question 6

Endurance athletes may take low doses, how many times the therapeutic dose do bodybuilders take?

Answer 6

Up to 100x.

Question 7

What is stacking?

Answer 7

Using more than one steroid at a time (supposedly enhances effectiveness).

Question 8

Steroid taking is often cycled. What does this mean?

Answer 8

The user takes the steroids for 6-12 weeks then abstains.

Question 9

What does ‘cycling’ supposedly do?

Answer 9

• Minimises tolerance
• Reduces occurence of side effects
• Maximises performance
• Minimises detection.

Question 10

What technique is often combined with cycling, and what does it mean?

Answer 10

Pyramiding - increasing the dose gradually until the midpoint of the cycle then decreasing again. Supposedly reduces withdrawal.

Question 11

Steroids administered in what way are potentially metabolised too fast in the liver to act?

Answer 11

Orally administered.

Question 12

What type of effects are variations designed to minimise?

Answer 12

Androgenic. Anabolic effect desired.

Question 13

What class of drugs are steroids and in what situations can they be possessed/used?

Answer 13

Class C - sold by pharmacists only, can be imported if only for personal use.

Question 14

How do steroids work?

Answer 14

Theoretically, they act at androgen receptors (present in cytoplasm of skeletal muscle) - they activate the receptor, which increases protein synthesis and muscle growth through regulating DNA transcription of specific genes.

Question 15

How does the androgenic effect of steroids work?

Answer 15

Testosterone is converted in some tissues to DHT, which has androgenic effects.

Question 16

How can steroids cause feminising effects?

Answer 16

Testosterone can be converted to estradiol by aromatase, which mediates the effect of testosterone on the CNS = feminising.

Question 17

What is the problem with the androgen receptors theory?

Answer 17

Some people argue that normally the receptors are already saturated.

Question 18

What are alternative mechanisms by which steroids could work, other than at androgen receptors?

Answer 18

• Steroids could induce receptor expression in muscle
• Androgens could be antagonists for glucocorticoid hormones, decreasing protein synthesis and increasing protein breakdown.

Question 19

What are the possible health consequences of anabolic steroid use?

Answer 19

• Cardiovascular: high BP, clotting, red blood cells, decreased HDL cholesterol.
• Liver: jaundice, peliosis hepatic, tumours.
• Skin and hair: oily skin, acne, baldness
• Growth effects: stunting in adolescents due to premature epiphyseal closure.
• Behavioural: increased libido, irritability and aggressiveness, dependence, moodswings, paranoia and confusion, insomnia
• Men: testicular shrinkage, reduced sperm counts, prostate enlargement, gynecomastia
• Women: menstrual abnormalities, voice deepening, hair growth, clitoris enlargement, decreased breast size.

Question 20

What did Pope et al (2000) find about increased irritability and aggression in steroid users?

Answer 20

84% experienced almost no change.
12% mild mania, 4% strong mania.
Differential susceptibility.

Question 21

Are steroids addictive?

Answer 21

To some extent - users seem to show withdrawal symptoms (fatigue, depression, insomnia, restlessness, anorexia and decreased libido.
May reinforce because of body image improvement.

Question 22

What have laboratory studies shown about the addictiveness of steroids?

Answer 22

Systemic and nucleus accumbens testosterone produces a place preference in mice which is blocked by D1/D2 antagonist (flupenthixol) (Packard et al, 1998).

Question 23

What evidence is there that steroids are not addictive?

Answer 23

• Don’t produce euphoria or elicit cravings during withdrawal.