Anabolic steroids toxicities

Anabolic steroids have been promoted as a means to foster protein synthesis and inhibit catabolism. Possibilities for considerable weight gain have been implied. In practice however these effects are disappointing, certainly in relation to the toxicity of these agents. In HIV-infected patients the administration of anabolic steroids appeared to result in a small increase in both lean body mass and body weight. The androgenic properties that all anabolic steroids have in common stand in the way of their therapeutic use. 

Steroids that aid in muscle development are called anabolic steroids. They are synthetic derivatives of testosterone, thus have the same muscle-building effect as testosterone. There are more than 100 different anabolic steroids which, vary in structure, duration of action, relative effects and toxicities. Androstenedione, stanozolol and dianabol are anabolic steroids. They are used to treat people suffering from traumas accompanied by muscle deterioration. The use of anabolic steroid can lead to a number of dangerous side-effects, including lowered levels of high density lipoprotein cholesterol, which benefits the heart, and elevated levels of harmful low density lipoprotein, stimulation of prostate tumours, clotting disorders and liver problems. 

An issue for inhaled corticosteroid treatment is patient compliance. Analysis of prescription renewals shows that corticosteroids are taken regularly by a minority of patients. This may be a function of a general "steroid phobia" fostered by emphasis in the lay press over the hazards of long-term oral corticosteroid therapy and by ignorance over the difference between corticosteroids and anabolic steroids, taken to enhance muscle strength by now-infamous athletes. This fear of corticosteroid toxicity makes it hard to persuade patients whose symptoms have improved after starting the treatment that they should continue it for protection against attacks. 

Use of androgenic steroids is likely to produce a sensation of energy and euphoria, but also with a tendency to sleeplessness and irritability (1). More extreme changes in mental state can result in extreme swings in mood, ranging from depression to aggressive elation. An unusual complication in one case was a toxic confusional state and choreiform movements caused by an anabolic steroid (SED-12, 1038) (29), but it may have been due to the non-specific results of endocrine stress in a susceptible individual. 

Tilzey A, Heptonstall J, Hamblin T. Toxic confusional state and choreiform movements after treatment with anabolic steroids. BMJ (Chn Res Ed) 1981 283(6287) 349-50. 

Although the toxic side-effects of drugs are less difficult to ascertain, the conclusions iawn from the available data are often circumstantial, e.g. the possible links between taking anabolic steroids and liver cancer. Nevertheless, there is sufficient evi-... 

Although the horse appears to be refractory to the hepatic effects of most NSAIDs, their hepato-toxic potential should be considered, especially when they are concomitantly administered with other potentially hepatotoxic agents, such as fluoroquinolones, potentiated sulfonamides or anabolic steroids. In addition, many herbal preparations are potential hepatotoxic agents and clients may administer these compounds concurrently with prescribed NSAIDs without consulting their veterinarian. Echinacea and kava kava products, for example, are reported to be potential hepatotoxins and both are used in herbal remedy products that claim to produce calming or sedating effects in horses (Abebe 2002). 

The other negative effect of anabolic steroids relates to steroid toxicity. Toxic steroids are primarily the oral ones and are subject to processing by the liver. This liver processing is harsh and is best avoided. When making the personal decision to use anabolic steroids, one would want to pay special attention to the better steroids which are low in androgenic properties and low in toxic properties. This consideration greatly reduces the side effects that could potentially be experienced on a steroid cycle. 

Many Anabolic/Androgenic Steroids (AAS) are available in an oral form. Unfortunately some are also quite toxic to the liver. Orally administered AAS are very susceptible to first pass liver deactivation unless chemical molecular structures are altered to make them harder to deactivate. When an oral AAS is swallowed it enters the stomach where it is partially broken down and passed to the small intestines. The small intestines contain a group of enzymes called CYP-450 s. These enzymes begin to break down the AAS further in an attempt to deactivate it. The AAS is then absorbed through intestinal mucosa cells and transferred to the liver portal vein for further deactivation into inactive chemicals such as etiocholanone. These chemicals are then conjugated with glucuronic acid and excreted in urine. Up to 100% of the original compound can be deactivated in this process which is known as first pass deactivation. 

Yet another classification system refers to the nature of the host s response to the causative agent. Some agents, referred to as intrinsic hepatotoxicants, will cause hepatotoxicity in most individuals of most species. In the case of idiosyncratic hepatotoxicants, where a chemical s toxic effects are a function of unusual susceptibility of the exposed individual, it may not be clear whether the lesion is a manifestation of the hepatotoxic properties of the substance in question or a manifestation of the individual s untoward response to the agent. This response may mean hypersensitivity (allergic) reactions or exaggerated responses to minor alterations in liver function. For example, anabolic or contraceptive steroids cause diminished biliary excretion (cholestasis) in most... 

Abuse of anabolic androgenic steroids may also lead to liver toxicity with intrahepatic cholestasis. Their use has also been associated with the development of benign adenomas and adenocarcinoma of the liver, and with other benign tumours. ... 

M. Neri, S. Bello, A. Bonsignore, S. Cantatore, I. Riezzo, E. Turillazzi and V. Fineschi, Anabolic androgenic steroids abuse and liver toxicity. Mini Rev. Med. Chem., 2011, 11, 430-437. 

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