By Thomas O’Connor, MD 3/13/16
Anabolic steroids were initially created/discovered in the 1930’s. Since this time, millions of people have used these medical agents for both personal and professional reasons. The fascination with anabolic agents continues to build as those looking for improvements in strength, muscle size in addition to mental wellness and optimizing sexual prowess realize that no other supplement can compare to these magical medicines.
For unknown reasons, the “traditional medical community” Has refused to acknowledge the sheer utility and numbers of users of anabolic steroids. Fortunately that is changing and since the time I started writing as the Anabolic Doc in 2009, many other physicians and health-care providers have excepted that people “use” steroids and that it’s time to provide medical services as to limit potential disease that we know can result from the use of these agents.
It goes without saying that my words should never be confused as a blessing for the use of these illegal and potentially dangerous agents, to the contrary, I am here to provide medical support for anabolic steroid users, to maintain an open-door policy for when they are ready to reach-out for help. To provide medical services to those that are suffering and equally as important, to educate those that have yet to take their first pill or injection.
Physicians take an oath to, “do no harm”. Allowing people to take medicines that we know can lead to disease, without saying anything, would be breaking that oath.
After 13 years of being involved medically with anabolic steroid users, I will list what I see as the top 5 medical issues that are important to be aware of. With this, I have to advise anyone who is using steroids or has used and is suffering or concerned to reach out to their healthcare provider and discuss these issues. You may be pleasantly surprised to see that your Doctor really wants to help you! Please feel free to print this article and show it to your doctor and use it as a talking point. You may know more about anabolic steroids than your doctor, but your doctor knows more about medicine than you- that’s for sure. Imagine you and your doctor as a team!
The top 5 medical issues related to anabolic steroids:
- Anabolic Steroid Induced Hypogonadism (A.S.H). Without doubt, this is #1. Most (young) steroid users do not know that using these agents can and will almost 100% over time lead to shutting down their natural testosterone levels and changing their brains, sometime permanently. PCT may protect against this and is ethically correct, at least in the early stages of cycling, but in the end, continuous/aggressive steroid use will lead most men to requiring life-long replacement androgen therapy. It’s a slippery slope- one cycle and some PCT without any issues- leads to another and another…. This is what I see. Please look before you leap. You may not be happy living on testosterone years down the road.
- Cardiovascular Disease. How steroids lead to heart disease is complex and multifactorial, yet VERY TRUE! This is the most important part of my healing!! Anabolic agents are known to worsen heart disease risk factors, such as: hypertension, poor lipid ratios- higher LDL and low HDL, cause obstructive sleep apnea and cause and enlarged heart- LVH. Other risks that steroids can cause are increasing red blood cell indices, hypercoagulable states and direct adverse effects on the heart muscle itself (cardiomyopathy) and damage to the endothelial aspect of the artery(s). This disease state can take decades to progress and men with poor family histories associated with early and severe heart disease are especially at risk! Diagnosing these issues early is very important, because in addition steroid discontinuation, physicians can play a very important role in providing protective medicines while someone is going through a dangerous period of steroid use. Treating hypertension, lipid abnormalities, polycythemia, sleep apnea, and other medical issues that may be caused by steroids is the ethical right thing to do and many good physicians will do this. Give a man time to make the right decision and not have a heart attack- has always been my perspective.
- Sexual Issues. This may be number 3 on the list, but without doubt it’s the #1 reason why men seek me out for medical care (I wish it was their hearts, but it’s their penis that really matters) Let’s be honest, anabolic steroids and their “use” is synonymous with testosterone. Almost every steroid cycle has testosterone as a base. Men on testosterone are horny. It’s funny that there was a recent medical article indicating that men on testosterone are horny. Reminds me of back in the 1980’s when the medical community was not sure there was enough proof that steroids lead to increased muscle growth! WOW! Here we go again. Men, even young men with normal testosterone levels experience increased libidos on steroids. The functional word here is “on” And any experienced steroid user learns quickly that being on steroids vs off, sex is very different. Again, in the beginning, most steroid users, with/without PCT experience only minimal side effects regarding sex. Over time, this can lead to severe impotence and depression.
THIS IS THE MOST COMMON REASON WHY MEN DO NOT AND CAN NOT STOP USING STEROIDS AND STAY ON STEROIDS FOR PROLONGED PERIODS AND EVEN FOR LIFE. This is another opportunity for me to stress the educational aspects of what I am providing the “steroid” and “non- steroid using” using community. Please be careful!!
- Prostate disease. Anabolic steroids and testosterone have marked affects on the prostate. The good news is that the literature for testosterone replacement has not shown any uptick in prostate cancer- although each man may be at risk! This cannot be said for super physiologic testosterone use and or anabolic agents– as there are no sound longitudinal studies on steroid use and prostate cancer. Non the less- unfortunately, I have played a role in the diagnosis of many a man’s prostate cancer. Only handfuls have been on testosterone and in almost all these cases, it was an elevating PSA that lead to the diagnosis. We assume that these few unlucky men had microscopic prostate cancer cells when they went on testosterone and the therapy lead to an accelerated growth of the cancer cells. Some physicians say this is controversial, but at the same time, needless to say deadly and each man needs to look-out for prostate cancer. SEE YOUR DOCTOR OR A UROLOGIST TO DISCUSS PROSTATE DISEASE.
- Psychiatric disease. I have heard it a million times, “Doc it’s not ROID-RAGE, it’s a guy who is an ass-hole and now an ass-hole on steroids!” After 13 years as a medical expert on steroids, I can tell you I have a hard time with this. I do agree that MOST men diagnosed with low T and on physiologic medically supervised testosterone (aside from steroid doses) are pretty cool cats. And there is an abundance of medical data indicating that men on testosterone replacement have improved depression scores. Anabolic steroid use is certainly not TRT, so to compare is wrong. Anabolic agents vary widely in their CNS affects and anyone educated in steroid use knows that Tren is not like a little Anavar- especially when it comes to aggression and sweating at night!! In addition to the psychiatric affects know regarding “using” steroids, the worst and potentially deadly psychiatric issues can occur after one stops using anabolic steroids- especially abruptly. For anyone who questions the dangerous of anabolic steroids and suicide- they can check-out the Taylor Hooton Foundation and talk to Don, Taylor’s Dad who lives with the sadness of his son’s suicide after a family doctor told him to “STOP STEROIDS KID” . With this I close this article and thank you all for being a fan.
Stay Strong and Healthy,
DR Thomas O’Connor, MD
Board Certified Internal Medicine
Clinical Instructor of Medicine
University of Connecticut School of Medicine