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Not those kind of Steroids!

Steroids are often ordered by physicians for multiple
problems. The problems can be anything from breathing problems to allergic
reactions. They are often confused with Anabolic steroids so we are frequently asked
if they are going to cause muscle growth.

Let’s talk….

There are two main types of steroids. Anabolic steroids are
a manmade version of testosterone, a male sex hormone. Medically, they are used
when there is not enough testosterone produced by the body. Delayed puberty or
chronic illness with muscle loss are two examples of medical use. These
patients are watched closely for side effects and the minimal effective dose is
used.

Unfortunately anabolic steroids are frequently misused for
building muscle and stamina, especially in athletes and body builders. They
generally use very high doses to get the effect they want, and therefore are
prone to very serious side effects. They include liver damage, fluid retention,
lower sperm counts, smaller testicles, mood swings, and aggression in men. They
can cause baldness, facial hair growth, mood swings and amenorrhea in women.
They also can cause stunting of bone growth and height in teenagers. They are
often bought on the internet and there is frequently pressure on young athletes
to use them to “stay in the game”. Parents of athletes should watch for the
above side effects as teenagers especially are frequently taking them without a
parent’s knowledge.

Corticosteroids are laboratory produced steroids that work
like cortisol that is produced by the adrenal glands in your body. If this is
added to the normal cortisol level, it works as an anti-inflammatory in the
body, preventing or slowing down the immune system from triggering
inflammation. So many disease are either caused by, or result in, inflammation.
COPD, Asthma, Rheumatoid arthritis,
Lupus, MS, Eczema are all inflammatory diseases and respond well to steroids.
They can be given by pill, injection, inhaler, cream or I.V. The most popular
name you will hear is Prednisone but there are many different versions.

These medications also come with side effects and you must
weigh the benefits very carefully before agreeing to take them. Again, the side
effects are dose related, including the amount of time you are on them. Short
term side effects can be hypertension, glaucoma, elevated blood sugars, mood
changes and weight gain in the abdomen, neck and a “moon face”. Long term side
effects are osteoporosis, diabetes, infections, thin “tissue paper” skin and
decrease in natural cortisol production (suppression of the adrenal gland).
Delayed healing is very common so any type of injury can be much more serious
than it usually would be.

Finally, you should never stop either type of steroids
abruptly. It can cause muscle pain, depression, sleep interruptions, fatigue
and moodiness. Discontinuing them quickly can also cause certain diseases to
rebound and symptoms to return. A physician directed taper is safer and less
likely to trigger side effects. Always keep track of how often you have taken
steroids in the past year. For example more than three steroid injections to
the body can increase the potential for all the problems discussed above. Most prudent
physicians try to avoid more than three injections per year, although there can
be some variations based on your individual situation or pain condition.

Citations

  • Waterbrook AL, Balcik BJ, Goshinska AJ. Blood Glucose Levels After Local Musculoskeletal Steroid Injections in Patients With Diabetes Mellitus: A Clinical Review. Sports Health. 2017 Jul/Aug;9(4):372-374. PubMed PMID: 28394710
  • Guo JR, Jin XJ, Shen HC, Wang H, Zhou X, Liu XQ, Zhu NN. A Comparison of the Efficacy and Tolerability of the Treatments for Sciatica: A Network Meta-Analysis. Ann Pharmacother. 2017 Jul 1;:1060028017722008. PubMed PMID: 28745066

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Last modified: August 18, 2017