Osteoporosis anabolic steroids

Stanozolol is an androgenic anabolic steroid used in cases of deficiency in protein synthesis and osteoporosis. In spite of its prohibition by the International Olympic Committee since 1974, this compound has been often abused by athletes and in horse-races to enhance performance (25). In recent times, the discovery of stanozolol at injection sites revealed its illegal use as a growth promoter in breeding, despite the ban in the European Union in effect since 1988 (26). 

The incidence of liver tumors following the use of androgens and anabolic steroids still cannot be calculated. What is clear is that if these products are used in high doses or over long periods of time (and there is now much doubt about whether they are more than marginally effective in such conditions as osteoporosis and aplastic anemia), techniques such as CT scanning and ultrasonography should be used routinely to ensure early detection of liver lesions. 

Anabolic effects Anabolic steroids can be used to treat senile osteoporosis and severe burns, to speed recovery from surgery or from chronic debilitating diseases, and to counteract the catabolic effects of externally administered adrenal cortical hormones. 

With regard to the development of osteopenia or osteoporosis with hypogonadism in males, lack of androgens is considered as a risk factor from the point of view of the quality of the bone. Anabolic steroids act on the bone probably through the androgen receptors on the osteoblasts, but an inhibitory effect on the osteoclasts is also possible. The condition affects mainly the cortical phase of the bone. When anabolic steroids are applied in females, they are usually combined with estrogens. Their application acts preventively against the loss of bone mass, stimulates osteoformation, and reduces the risk of hip fracture. 

The combined effects of vitamin D, calcium, and anabolic steroids in the treatment of senile osteoporosis have been investigated (71). Neither methandienone nor vitamin D3 alone but only the two together seemed to increase coronary morbidity and mortality, and possibly in women only. Simultaneous use of these two drugs should be avoided. 

Bone composition, such as mineralizahon, carbonate accumulation, crystallinity and collagen crosslinking, has been shown to change with age [41], and is correlated with the bone s mechanical properhes [42, 43]. In microdamaged bone, the collagen crosslinking is altered but the mineralization and crystallinity are unaffected [44] (Figure 14.6). Alterahons in bone composition have been observed in diseases such as osteoporosis [45], osteopetrosis [46] and osteoarthritis [47]. The treatment of osteoporosis with nandrolone decanoate, an anabolic steroid, was shown to alter the cortical bone composition [48], whereas treatment with bisphos-phonates had little effect [49]. 

Ethylestrenol (4 mg p.o. daily) is an anabolic steroid that is used to promote weight gain to combat tissue depletion, anemia and to overcome the catabolic effects of corticosteroids, osteoporosis, immobilization, and debilitation. Ethylestrenol enhances the production of erythropoietin by the kidneys and hence increases the red blood cell mass and volume (see Figure 95). Ethylestrenol may retain electrolytes and fluid and hence may become detrimental in patients with severe cardiac and renal diseases. Ethylestrenol is contraindicated in prostatic hypertrophy with obstruction and severe types of cancer (see also Table 8). 

Low testosterone concentrations frequently are seen in patients with ED, aging, type II diabetes, HIV/AIDS, osteoporosis, depression, obesity, alcohol abuse, anabolic steroid abuse, chronic inflammatory disease, cancer, and glucocorticoid use. 

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