11. Acute Steroid Safety: Studies with Real-World Dosages

Few medicines have the type of stigma about them that anabolic/androgenic steroids do. If you mention the decision to use these drugs to the average person, you are likely to be lectured about the tremendous physical and psychological risks you are about to undertake; how your hair might fall out, your testicles will disappear, or the steroids will give you cancer. Or maybe you will just lose you mind to uncontrolled fits of psychotic rage, or suffer a lifethreatening heart attack. Clearly, the public has been given a very strong message about steroids: stay far away from them, they are deadly drugs. However, those actually taking anabolic steroids usually see things very differently. They believe the dangers are terribly exaggerated in the media, and the risks of serious injury or death from an isolated steroid cycle are exceedingly low. Which position is correct?

The committed steroid user will usually point out the fact that a review of the medical literature over the past 50 years will show that the overall safety profile of these drugs has been quite favorable. Steroid opponents, on the other hand, point out that an illicit user takes a much larger dose of steroids than those used in medical situations, and are in much greater danger than the patients using them. Who is right? Is the isolated steroid cycle really a serious health risk? One thing that has always confounded this debate is the lack of pertinent medical studies. Medical ethics make high-dosed studies with anabolic/androgenic steroids (which may constitute abuse of the medication) very difficult to design and gain approval for. Only a very small number of clinical studies actually provide environments that could be viewed as relevant to those on both sides of the argument.

In this section, we examine three medical studies that appear highly relevant for examining real-word acute anabolic/androgenic steroid safety. They concern not therapeutic doses, but a supratherapeutic level and duration of intake that any illicit steroid user would recognize as sufficient for improving muscle mass, strength, and performance. In fact, the dosages and administration periods used in these studies reflect those taken by some of the more aggressive steroid-using bodybuilders and strength athletes. A fairly comprehensive set of health markers were assessed during these three investigations, including insulin sensitivity, serum cholesterol and triglyceride, prostate specific antigen (PSA) levels, and liver enzymes. Because of the protocols that were used, these studies give us a fairly good basis to evaluate the negative health impact of anabolic/androgenic steroids, at least as it relates to an isolated cycle.

600 mg/wk of Testosterone

The first is a testosterone dose-response study published in the American Journal of Physiology Endocrinology and Metabolism in July of 2001, which looked at the effects of various doses of testosterone enanthate on body composition, muscle size, strength, power, sexual and cognitive functions, and various markers of health. 61 normal men, ages 18- 35, participated in this investigation. They were divided into five groups, with each receiving weekly injections of 25, 50, 125, 300, or 600 milligrams for a period of 20 weeks. This treatment period was preceded by a control (no drug) period of 4 weeks, and followed by a recovery period of 16 weeks. Markers of strength and lean body mass gains were the greatest with larger doses of testosterone, with the 600 mg group gaining slightly over 17 pounds of fat-free mass on average over the 20 weeks of steroid therapy. There were no significant changes in prostate-specific antigen (PSA), liver enzymes (liver stress), sexual activity, or cognitive functioning at any dose. The only negative trait noted was a slight HDL (good) cholesterol reduction in all groups except those taking 25 mg. The worst reduction of 9 points was noted in the 600 mg group, which still averaged 34 points after 20 weeks of treatment. All groups, except this one, remained in the normal reference range for males (40- 59 points).

600 mg/wk of Nandrolone

Next we look at a study conducted with HIV+ men, which charted the lean-mass-building effects of nandrolone decanoate. 30 people participated in this investigation, with each given the same (high) weekly dose of this drug. Half underwent resistance training so that two groups (trained and untrained) were formed. The dosing schedule was quite formidable, beginning with 200 mg on the first week, 400 mg on the second, and 600 mg for the remaining 10 weeks of peak therapy. Doses were slowly reduced from weeks 13 to 16 to withdraw patients slowly from the drug. Potential negative metabolic changes were looked at closely, including cholesterol and lipid levels (including subfractions of HDL and LDL), triglycerides, insulin sensitivity, and fasting glucose levels. Even with the high dosages used here, no negative changes were noted in total or LDL cholesterol, triglycerides, or insulin sensitivity. In fact, the group also undergoing resistance exercise noticed significant improvements in LDL particle size distribution, lipoprotein(a) levels, and triglyceride values, which all indicate improved cardiovascular disease risk. Carbohydrate metabolism was also significantly improved in this group. The only negative impact noted during this study was a reduction in HDL (good) cholesterol values similar to that noted with the testosterone study, with an 8-10 point reduction noted between both groups.

100 mg/day of Anadrol

Lastly, we find a study looking at the potent oral steroid oxymetholone (Anadrol).331 This steroid is thought to be one of the most dangerous ones around by bodybuilders, who as a group seem to treat it with both a lot of respect and caution. It is not common to find them exceeding the doses and intake durations of this investigation, making it a very good representation of real-world Anadrol usage. This study involves 31 elderly men, between the ages of 65 and 80. The men were divided into three groups, with each taking 50 mg, 100 mg, or placebo daily for a 12-week period. Changes in lean body mass and strength were measured, as well as common markers of safety including total, LDL and HDL cholesterol levels, serum triglycerides, PSA (prostate-specific antigen), and liver enzymes. Muscle mass and strength gains were again relative to the dosage taken, with the end results being similar to those noted with 20 weeks of testosterone enanthate therapy at 125 mg or 300 mg per week (about 6.4 and 12 lb of lean body mass gained for the 50 mg and 100 mg doses respectively). There were no significant changes in PSA, total or LDL cholesterol values, or fasting triglycerides; however, there was a significant reduction in HDL cholesterol values (reduced 19 and 23 points for the 50 mg and 100 mg groups respectively). Liver enzymes (transaminases AST and ALT) increased only in the 100 mg group, but the changes were not dramatic, and were not accompanied by hepatic enlargement or the development of any serious liver condition.

Adding It All Up

One hundred and twenty-one men participated in these three studies, which involved the use of moderate to high doses of steroids for periods of three to five months. Although it may be shocking to most opponents of anabolic/androgenic steroid use, an unbiased assessment of the metabolic changes and health risks did not reveal any significant short-term dangers. The main negative impact of steroid use in all three cases was a reduction in good (HDL) cholesterol values, which is a legitimate concern when it comes to assessing one’s risk for developing cardiovascular disease. It is uncertain, however, if a short-lived increase in this particular risk factor relates to any tangible damage to one’s health over the long-term. It is also unknown how much (if any) this may be offset by the other positive metabolic changes that were seen to accompany combined AAS use and exercise.

Logic would seem to suggest that the isolated use of steroids, under parameters similar to those used in these three studies, should entail relatively minimal risks to health. At the very least, it is extremely difficult to argue that an isolated cycle with a moderate drug dose is tantamount to playing Russian roulette with your body, as most media campaigns against the use of these drugs would seem to suggest. But make no mistake. These same study results consistently demonstrated pro-atherogenic changes in blood lipids with the doses necessary for physique or performance enhancement, and underline how it is that long-term anabolic/androgenic steroid abuse can impair cardiovascular health.

References

Wlliam Llewellyn (2011) - Anabolics

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