Steroids are a group of organic compounds (class of biomolecules called lipids). Steroids are either anabolic (aid in muscle building) or androgenic (inducing male sexual characteristics). Steroids have been used illegally by prominent sportspersons/athletes to boost their performance, and legal norms were therein enforced in the possession of steroids. Steroids have been used to induce maleness in trans-sexual women, in orchidectomy or removal of testis in cases of testicular cancer etc.

However, steroid use ill-effects include lowering the levels of HDL cholesterol (High density lipo-protein), increasing LDL, thus causing cardiovascular diseases as is aromatization, premature baldness, stunted growth, fetus& immune system affectation. Steroids bind to ‘androgenic receptors’ located on the cell membrane inducing certain phosphorylation reactions in the cell resulting in the expression of specific genes to produce proteins which build muscle mass. The flop side though being so big raises one’s eyebrow in steroid use and administration.

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Scientifically, steroids are defined as a group of organic compounds which belongs to a major class of biomolecules called “lipids” and are easily soluble in organic solvents (Ex. Benzene) and sparingly soluble in water. They have a basic fused four ring structure called “cyclopentanoperhydrophenanthrene”1. The most abundant steroid in our cells is cholesterol, which forms the membrane of the cells and is the precursor molecule for the synthesis of chemical messengers called “hormones”2 that regulate the physiology of cells. Steroid hormones include estrogens (by ovaries), androgens (by testes), aldosterone (by adrenal cortex) and so on.

Anabolic androgenic steroids (AAS), also called juice, roids, gym candy, pumpers and so on, are industrially manufactured substances that are structurally related to male sex hormones (androgens) such as testosterone. ‘Anabolic’ refers to ‘muscle building’, while ‘androgenic’ refers to ‘induction of male sexual characteristics’. Athletes all over the world use these substances illegally before important competitions to improve their performance and fitness/alertness levels and also claim that it improves their physical appearance.

Below discussed are the history, legality, uses and abuses of such drugs. When did it all begin? Since time immemorial mankind has always had an undying urge to compete and obtain victory. Especially, athletes have always wished to transform their bodies in powerful, mean machines. Epics suggest that Greek athletes ate large amounts of meat for building muscle. However, development of science and technology has led to the use of drugs and non food substances to improve performance. And such a usage, called doping was first charged on swimmers in Amsterdam in the 1860s.

Doping, ever since then has been observed in almost all other sports. Doping began with doses of strychnine, caffeine, cocaine, heroin etc. But the use of anabolic androgenic steroids (AAS) began only in the 1940s, as testosterone was chemically synthesized in the 1930s. In the Olympics held in 1952, an American pharmacologist noted that the Russian weight lifting team won many medals due to the use of synthetic testosterone and in 1958, a U. S pharmaceutical company commercially released a range of anabolic steroids.

By the time the company realized the harmful side effects of its products, the products were in use by sports stars all over. By 1970s the demand for steroids grew greatly and a black market began to spring to satisfy the needs for non medical usage of steroids. Disqualifications began to occur for athletes who test positive in the dope test. The publicized disqualification of Canadian sprinter Ben Johnson after winning the 100m dash in 1988 Seoul Olympics as he tested positive for stanozolol3 caught the world’s attention to a major problem.

Ever since there have been efforts to prevent doping and punish the offenders. In 1999, World Anti-Doping Agency (WADA) was formed to test the athletes’ blood and urine for doping prior to the Olympics. Despite all these efforts abuses of these drugs continues among both athletes and non athletes. Legality issues Anabolic androgenic steroids are classified as controlled substances under U. S federal law and the laws of many states. Non medical possession and sale of these drugs are illegal.

In mid 1980s when the use of steroids by athletes was a major concern, the Anabolic Steroids Control Act was passed in the year 1990. Just the possession of Schedule III drugs that include amphetamines, methamphetamines, opium and morphine is punishable by a year of imprisonment and/or a fine of $2500. An individual who sells steroids or possesses it with the intention of selling it can be imprisoned for up to five years and/or a fine of $250,000. Many athletes who self administer steroids have no idea about the legal consequences. Uses of steroids

Orchidectomy or the removal of testis is unavoidable in males in cases of testicular cancer. In such situations the males are given doses of testosterone orally to maintain their secondary sexual characters. Pituitary glands produce hormones which include TSH (thyroid stimulating hormone), ACTH (adrenocorticotrophic hormone), GH (growth hormone) and so on4 and the disorders in these glands often produce symptoms such as retarded growth, excess growth or dwarfism, delayed or absence of sexual development at puberty (small testes, lack of pubic hair, loss of body hair etc).

In such patients, anabolic steroids are injected when the age of puberty is attained. This leads to growth and development of secondary sexual characters. Certain kinds of surgery and cancer cause severe muscle loss after the patient has recovered, anabolic steroids in addition to proper diet and exercise are prescribed for the patient to build muscle. It is used to induce maleness in transsexual women who want to be permanently masculinized. However, this is not legal in the United States.

Researchers are working on anabolic steroids to be used as oral contraceptive pills. Abuses of steroids Addition of a hormone externally signals the endocrine system to stop the production of the hormone. So when not just testosterone but any kind of anabolic steroid is introduced into the blood, the body signals the testes to limit or totally stop the production of testosterone. But this inhibition is only as long as the steroid is supplemented. This results in sterility and the sterility induced by steroid use is temporary and can be reversed.

The steroids lower the levels of HDL5 (high density lipoprotein) referred to as the ‘good cholesterol’ as these help in transporting excess of cholesterol from the cells to the liver for breakdown and in turn prevent the accumulation of cholesterol in the arteries and increase the levels of LDL (low density lipoprotein) called the ‘bad cholesterol’ as they transport the ingested cholesterol to the cells. This could also be the reason for linking excessive steroid use to cardiovascular diseases such as cardiac arrhythmias, sudden myocardial infarctions, congestive heart failure and so on.

When anabolic steroids are used by pregnant women, fetal development can be affected. This causes male features in female fetus and vice versa. There are evidences that prove that steroid intake can result in an increased activity of the liver as it has to synthesize enzymes extensively which can be harmful over a long period of time. The increased testosterone in the body due to steroid usage increases the activity of the enzyme aromatase which converts testosterone to estrogen. This reaction is called “aromatization”6.

The excess estrogen in males settles in its receptors located in the breast tissue. This causes “gynocomastia”, a process defined as the development of breast tissue in males. Anabolic steroids when consumed by women causes virilization that is the process by which masculine charateristics are observed in those women. The symptoms of this process are deeper voice, enlargement of clitoris, excess of body hair growth, male pattern baldness and acne. This process is very difficult to reverse.

Steroid use can result in premature baldness as DHT7 (dihydrotestosterone), which is a byproduct during the breakdown of steroids reacts strongly with the scalp causing hair fall. The skin has oil secreting glands called ‘sebaceous’ glands which have affinity to DHT and increased activity of these glands increases bacterial activity on the skin as a result causing acne. Significant data suggests that steroid use results in psychiatric problems including psychosis, violence, mania. When used by people who still have a developing body, anabolic steroids can cause stunted growth.

Aromatizable steroids can cause the closure of the epiphysial cartilage, which is mainly functional in lengthening of the bone and this in turn results in a shorter adult height. Research on steroids suggests that anabolic steroids have an effect on the immune system of the human body. Testosterone and some of it analogues have been found to repress the immune system leading to frequent infections, while Nandrolone and its analogues stimulate the immune system easily. Athletes abstain from aerobic activity when they are on steroids in order to gain bulk.

This increases blood circulation. Also the anabolic steroids cause water and sodium retention in the body. These contribute to an increase in the blood pressure. Kidneys are organs which are involved in blood filtration and excretion. The anabolic steroids cause stress on the kidneys, resulting in dark colored urine. Unless sufficient amount of water is not consumed, the kidneys can seriously be damaged. Anabolic steroids can result in the enlargement of the prostate gland. This enlargement is found to be due to the action of DHT on the body. How do steroids work?

It is well known that steroids cause an increase in muscle mass. Different steroids have different mechanisms of action. The general mechanism is that anabolic steroids bind to receptors called ‘androgenic receptors’ located on the cell membrane. This binding induces certain phosphorylation8 reactions in the cell resulting in the expression of specific genes to produce proteins. muscle is mainly made of water and proteins. the proteins produced by the cell, triggered by the action of steroids is used to build muscle. Oxandrolone is a steroid that acts by this mechanism.

Some steroids affect the action of a hormone called cortisol which mainly functions to breakdown the old muscle cells. Anabolic steroids also work by altering the differentiation of cells. They inhibit the formation of cells for fat storage and favor the formation of muscle cells. From the list of abuses of steroids it can easily be concluded that unsupervised illegal utilization of anabolic steroids can seriously damage not just health but normal life too. This is a huge price to pay for and one must analyze if the risk is worth all the ill effects.