Page not availableI had a chance earlier today to visit with the production crew from Mississippi Public Broadcasting. The authors noted that testosterone replacement therapy was often prescribed without an established diagnosis of low testosterone anaboliv hypogonadism. The history of anabolic steroids dates to the anabolic steroids congestive heart failure when the chemical structure clobetasol propionate lotion price the male sex hormone testosterone was elucidated. Soon afterward, chemical synthesis of testosterone was possible in the laboratory. The group of medications that we call anabolic steroids are synthetic derivatives of testosterone.
Anabolic Steroids Increase Risk for Heart Disease in Young and Middle-Aged Men
I had a chance earlier today to visit with the production crew from Mississippi Public Broadcasting. The authors noted that testosterone replacement therapy was often prescribed without an established diagnosis of low testosterone levels hypogonadism.
The history of anabolic steroids dates to the mids when the chemical structure of the male sex hormone testosterone was elucidated. Soon afterward, chemical synthesis of testosterone was possible in the laboratory. The group of medications that we call anabolic steroids are synthetic derivatives of testosterone. These medications have a variety of arcane names including: The anabolic steroids have 2 major groups of effects: The various available steroids differ from one another in the relative potency of these 2 sets of effects.
Food and Drug Administration has approved the use of anabolic steroids for: These medications can be delivered orally, intravenously, by intramuscular injection, or by transdermal patch. The anabolic steroids should not be confused with the corticosteroids that are much more commonly used in clinical practice.
In the anabolic steroids were added to Schedule 3 of the Controlled Substance Act, making it a federal crime to possess these drugs in the United States without a prescription. For context, other drugs in Schedule 3 include the barbiturates, LSD precursors, ketamine, and some narcotic analgesics. The laws regarding the prescription and possesion of anabolic steroids vary from country to country.
The anabolic steroids have been used for decades by athletes of many different sports to gain competitive advantage. Used for this purpose, these drugs are often taken at many times the conventional prescription dosage. At these dosages, the anabolic steroids lead to an increase in muscle mass and likely potentiate the effects of exercise on gaining additional muscle mass and strength.
As such, these drugs are banned by the entire Olympic movement and by all sports organizations that adhere to the WADA code. The number of Americans currently using anabolic steroids is unknown, but some estimates have placed that number at more than 3 million.
Many unwanted side effects have been attributed to anabolic steroids. Some are drug-specific and dose-dependent. The list of adverse effects of anabolic steroids includes: In order to avoid the unwanted side effects of gynecomastia and weight retention, men who use steroids sometimes also take drugs eg, Arimidex that limit conversion of the steroids to estrogen.
Our understanding of the cardiovascular effects of the anabolic steroids comes from a relatively small set of observations made in athletes taking these medications and from a small number of animal studies. Retrospective human studies in this area suffer from important methodologic problems such as: Some, but certainly not all studies, have shown an increase in blood pressure attributed to anabolic steroids. This issue has been difficult to study in power athletes because of the myriad of factors that influence the blood pressure, including weight-lifting itself.
There are certainly anecdotes of finding cases of severe hypertension in athletes who have no other obvious cause than steroids. The amount of blood pressure elevation associated with long-term use of steroids appears to be mild to moderate and the effect may subside if the steroids are stopped.
The majority of studies show that anabolic steroids have an unfavorable effect on the serum lipid profile. The exact mechanism for these changes has not been established. These changes are thought to develop within weeks of starting steroids and can linger for months after these medications are stopped, despite a relatively short pharmacologic half-life measured in days.
Some studies have suggested that the oral route of administration may be worse in this regard than the injectable route.
These unfavorable changes in the serum lipid profile are noteworthy because there is considerable evidence that high LDL and low HDL levels are associated with increased risk for coronary artery disease, heart attack, and stroke.
Athletes who use anabolic steroids are often found to have thickening of the muscular walls of the left ventricle that we call left ventricular hypertrophy LVH. The degree of hypertrophy can range from mild to severe. But to date, there has not been a long-term, carefully controlled, prospective study to help sort out the precise effects of steroids. The data regarding which portions of the left ventricle become hypertrophied have been inconsistent, but it appears that the resulting LVH may not be uniform throughout the chamber.
This appears to be a rare event. In the absence of any other explanation, it might be easy to ascribe such deaths in otherwise healthy athletes to the steroids. But we can only speculate now about the mechanism by which steroid use might predispose the athlete to SCD. Nonetheless, there have certainly been athletes with SCD where autopsy findings have shown severe LVH or cardiac fibrosis which might predispose to arrhythmias where no potential cause except the steroids was obvious.
The cause-and-effect relationship between steroids and MI is not completely understood, but we know from animal studies that the steroids may increase platelet aggregation—a step that occurs clinically during sudden blockage of one of the coronary arteries during acute MI.
This may also play a role. The precise epidemiologic link between steroid use and mortality is yet to be established. One interesting recent study from Sweden identified users of anabolic steroids by blood tests toxicology screen that were administered during evaluations for some other medical problem.
The investigators found that, over a several-year period, the mortality rate for users was times that for non-users. The study was not controlled, though for many other, potentially important, factors that influence mortality. To reiterate, our current understanding of the adverse cardiovascular effects of anabolic steroids is based on rather limited information gathered from a small number of research studies.
Going forward, we are unlikely to have large-scale prospective studies to gather more information and additional retrospective studies are likely to have the methodologic pitfalls I mentioned above.
Given our current understanding, athletes who choose to use anabolic steroids should be aware of the possibilities of high blood pressure, unfavorable lipid profile, structural changes in the heart, and even heart attack or SCD. But how safe is it? I think you need to look at other drugs such as clenbuteral and cocaine which are widely used among body builders to get lean, not to mention diuretics. They also use recreational drugs, maybe look at the gay body building scene separately. Show me a study based solely on androgen anabolics or come and see me and stop speculating and creating media drama for your own recognition which I consider unethical for an intelligent doctor.
I anxiously await your reply and further information based on strict scientific facts which you have currently not presented. He is only reporting the studies and giving a very impartial conclusion and even admitting more research is needed. Interesting read I came across due to my own research of my health issues. Though maybe not that extreme I was very curious about the gains through anabolic steroids.
Through an associate I gained a supply of testosterone and trenbolone acetate. The Tren being the most suspect. I ran a cycle for 12 weeks stopoing the tren on the 10th week.
I experienced sevearl of the common symptoms for tren namely water retention, reduced cardio, and night sweats and shrugged these off as normal. Ending the cycle I was having more and more difficulty breathing and swelling in my ankles and feet.
Finally one night I absolutely could not breath and was rushed to ER. Diagnosis severe congestive heart failure. I do not think so. I have questioned the doctor about it and searched the internet and like stated above no one can answer.
Hopefully more research can be done and I will gladly participate. I have been using oral and injectable steroids for muscle enhancement for 25 years. This year, at the age of 57, I had to have open heart surgery to bypass all the blockages in the arteries feeding my heart. I had to have six bypasses. The doctors were surprised someone as young as me had this much of a problem.
There is no family history. They said I was about ready to drop dead. I also have aortic stenosis that is mild at this time. They say the valve could last me 5 to 15 years before it needs to be replaced. I am sure the steroids caused the problem but I am going to keep using them because now my own testosterone production is pretty much gone. If I could go back and talk to the younger me, I would tell him not to use steroids.
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