by Ed Barillas, Staff Writer
Your liver is located behind the lower ribs, right below the diaphragm on the right side of the abdomen and for all intents and purposes, it is your life. It averages slightly more than three pounds in weight and is six inches thick. Without a functioning liver, you’d die a horrible death as common food elements like protein would put you into a coma since the by-products of protein metabolism, such as ammonia, would increase in the blood and cause havoc. In fact, many common food elements and drugs would be fatal if you didn’t have this organ around to render them innocuous and harmless. The liver is a potent chemical-processing plant as it quietly performs more than 500 vital functions, including the manufacturing of bile, which is needed for complete fat absorption. It also converts protein, carbohydrate and fat into other elements. It stores nutrients such as fat-soluble vitamins A,D, E, and K; vitamin B12 and carbohydrate as glycogen. It metabolizes drugs, including alcohol and cleanses the blood of toxins. It produces blood-clotting factors, without which a minor cut could prove fatal. It maintains blood glucose levels by way of liver glycogen breakdown and releases it into the blood as glucose. It synthesizes cholesterol and protein carriers for cholesterol in the blood. And it produces immune factors that protect against disease.
This is just a short list, but this should be enough to make you realize how important that organ really is and how important it is for you want to maintain proper liver function for maximum health. There are many things are known to harm the liver, including excessive alcohol intake and drug use. From an athletic point of view, certain types of anabolic steroids are frequently mentioned as having bad effects on liver function, such as oral drugs that are classified as 17-alpha alkylated drugs.
The designation “17-alpha alkylated” refers to a change made on position 17 of the basic steroid structure. Scientists developed the testosterone derivatives after noting that orally taken testosterone is degraded in the liver in a process called first-pass metabolism. Drug developers circumvented that formidable problem by making testosterone available in an injectable form as this bypasses initial first-pass liver metabolism, and by manipulating the basic steroid chemical structure, as is the case with oral 17-alpha alkylated anabolic steroids.
While the structural change in oral anabolic steroids did result in a far slower rate of breakdown in the liver, it also led to an inordinate buildup of such drugs in the liver. Since the injectable versions of steroids do not build up in the liver as much as oral versions, the injectables are considered less of a problem in terms of normal liver function.
The oral drugs adversely affect the liver through several mechanisms. To start with, they interfere with the function of certain liver enzymes as anabolic steroids are known to increase the activity of some liver enzymes while downgrading that of others. One enzyme in particular that’s increased with oral anabolic steroid use is hepatic triglyceride lipase, which degrades high-density lipoprotein (HDL), which is a beneficial cholesterol carrier in the blood. A lowered HDL level is considered a risk factor for cardiovascular disease. Athletes who use oral anabolic steroids nearly always show depressed HDL levels as the buildup of 17-alpha alkylated oral anabolic steroids in the liver leads to a type of toxic or chemical hepatitis. Hepatitis is a general word for an inflammation of the liver and can be caused by various factors, such as drug use and viruses. Oral steroids cause liver inflammation by promoting an increase in the size of liver cells, which leads to a congestion of bile flow through ducts in the liver that empty into the gallbladder, where bile is stored.
The interference with bile flow induced by the effects of anabolic steroids on liver cells is called cholestasis. This usually occurs only in people who use higher doses of oral steroids, or who use such steroids for extended periods of time. There are certain oral steroids which are reputed to have more potent toxic effects in the liver and promote the liver swelling that can lead to cholestasis. They include oxymetholone (Anadrol-50) and fluoxymesterone (Halotestin), although it may be that those drugs cause problems because they’re often used in higher doses than other oral steroids. Both drugs are 17-alpha alkylated, as are most oral steroids.
It is well known that most cases of serious liver ailments due to oral anabolic steroid use have involved hospitalized patients who were given oral steroids such as Anadrol-50 to combat rare blood anemias. Many stayed on oral steroids for three or more years. The consensus of medical reviews is that certain potentially adverse liver changes do occur with athletic use with the extent of the changes depending on the drugs used, the doses and the length of time. However, the changes regress when the athletes stop using the steroids. The liver is known to have an amazing capacity for regeneration unless it’s irrevocably damaged, a scenario that rarely occurs with short-term steroid use.
Physicians also warn about elevated liver enzyme levels due to oral anabolic steroid use. While that could show an inflammation of the liver, the issue is that some of the measured liver enzymes aren’t specific to the liver and exist in other tissues. For example, two enzymes found in liver, ALT and AST, also exist in muscle. Also any type of injury to a muscle including the kind that occurs with intense weight training can cause an elevation of those enzymes in the blood. A physician who’s not looking at the large picture or measuring levels of other liver and muscle enzymes may wrongly conclude that such liver enzyme increases are indicative of liver problems. Measuring enzymes such as creatine kinase and GGT would provide a more definitive picture of existing liver function, as would liver imaging tests.
One visible early sign of liver inflammation due to oral steroid use is jaundice, which is characterized by retention of bile in the body, leading to a yellow discoloration in the skin and whites of the eyes so anyone using oral anabolic steroids should stop using them immediately if such symptoms occur. If you ignore the symptoms, you’re at risk for a more serious liver complication.
Those who are concerned about liver cancer should be conscientious about avoiding contracting all forms of viral hepatitis, which is considered a direct cause of the type of liver cancer that’s more fatal than the type usually caused by steroid use. Since such forms of hepatitis are caused by blood contact, be wary of tattooing, body piercing, acupuncture and even sharing razors and toothbrushes.
These are just some of the issues that one should take into consideration but if noted your liver should be able to take care of you for a very long time.