Biological Effects of Steroid Use - Research Paper Example

Biological Effects of Steroid Use Androgenic-anabolic steroids generally refer to drugs that are chemical variations of testosterone such as nandrolone decanoate, methandienone, stanozolol, androsterone, androstane or even progesterone (McEwen, 1991). There are over 40 variations known to date (Chyka, 2003). Several of these androgenic-anabolic steroids have been given approval by the United States Food and Drug Administration to treat a variety of conditions such as renal failure and immunedeficiency virus. When used to treat conditions such in legal doses, the appearance of side-effects is rare (Achar et al, 2010). However, several people, mainly athletes, tend to abuse androgenic-anabolic steroids to increase performance by increasing lean muscle mass, reduce fat and improve appearance. Adolescents also use them sometimes to engage in high-risk behaviors (Achar, 2010; Chyka, 2003). All the main sporting bodies have banned the use of steroids but its use continues to be widespread with varying numbers of individuals being reported to be using steroids. On average, these individuals tend to use between 5 to 15 times the recommended dose (Achar et al, 2010) and these are taken in the form of creams, gels, drug-delivery patches, orally or injected intramuscularly (Chyka,2003). The longer a steroid is abused, the greater the risk of harm to the human body (Achar et al, 2010). There are four key unfavorable target effects of steroid abuse and these are effects on the effects on the cardiovascular, hepatic, reproductive, and behavioural functions (Chyka, 2003) This paper will attempt to take look at these main biological effects that androgenic-anabolic steroids have on the human body. For the remainder of the paper, the term steroid will be used to refer to androgenic-anabolic steroids. Unfortunately, it is extremely difficult to gauge the extent to which steroids are abused by the general population and hence to determine their effects. Abusers of steroids are extremely reluctant to participate in medical research and admit that they do in fact abuse steroids. In addition, due to ethical reasons, it is impossible to carry out an experiment in a labortary setting using the dosage of steroids that many abusers use (Chyka, 2003). The main methods employed by researchers to collect data are clinical studies, laboratory studies of steroids in normal volunteers, and naturalistic studies of people abusing steroids (Pope and Katz, 1994). One of the main biological effects of steroids is that it both directly and indirectly effects on the heart. Several studies have pointed to an increased risk of left ventricular hypertrophy in abusers of steroids. This condition appears to persist in a person even after the use of steroids is ceased. The direct effect may be by the steroids binding to androgen receptors which can directly lead to hypertrophy. Alternatively, steroids may act indirectly by initiating hypertension which then affects the heart muscle. In fact, studies have revealed that it a unique form of left ventricular hypertrophy that is observed in abusers of steroids which is characterized by changes in the texture of the myocardium on an echocardiography (Achar et al, 2010). In a number of limited cases, it has been observed that the abuse of some steroids has also been linked to acute myocardial infarction and fatal ventricular arrhythmias (Achar et al, 2010). Another detrimental biological effect of the use of steroids has been an increased number of abnormal plasma lipoproteins. Low-density proteins have been observed to increase in a number of studies that were done with athletes while high-density lipoproteins fall drastically (Achar et al, 2010). A reason for why this happens has yet to be hypothesized but it is known that these abnormal levels of plasma lipoproteins can increase the likelihood of coronary artery disease by up to six fold (Achar et al, 2010). While a plentiful number of studies have looked at the above effects described, it must be noted that several abusers of steroids tend to abuse growth hormone, erythropoietin, and substances containing creatine, ephedra alkaloids, and herbal supplements, in conjunction with steroids. This is relevant as growth hormone is known to cause abnormal lipoprotein profiles, left ventricular hypertrophy and can lead to cardiomyopathy. Erythropoietin has been linked with hypertension and increased incidence of thromboembolic events. Almost none of studies conducted thus far took into account the use of these substances and as the effects are similar to steroids, it may be extremely difficult to differentiate between them clinically (Achar et al, 2010). In addition to the issue of abusing multiple drugs, other factors that make it difficult to pinpoint is because many steroid abusers are athletes and they consume specialized diets. Also, other multiple risk-taking factors may playa part such as having unprotected sexual intercourse with a number of partners (Chyka, 2003). In addition to the effects already discussed, another effect of steroid abuse may be an increased systolic and diastolic blood pressure in people taking steroids. Whether this effect is actually due to steroid abuse is controversial as several studies have indicated this is the case while an equal number dispute it. If a high blood pressure is seen, it is most likely due to the renal retention of sodium from the steroids under use. When a higher dose of steroids is taken, there is a higher amount of sodium retained (Achar et al, 2010). Steroid abuse has also been linked to altered endothelial cell growth. Steroid abuse can result in an anti-proliferative effect, the induction of apoptosis and modification of the levels of calcium in the cell. Endothelial cells, performing their normal function is crucial for cell growth and the repair of tissues (Michiels, 2003 from D’Ascenzo et al, 2007). These results have suggested that these are possibly the events that lead up to damage at a cell vasculature level (D’Ascenzo et al, 2007). Apoptosis is known to be essential to the development and differentiation of cells and any interference in this process can lead to damage (Michiels, 2003 from D’Ascenzo et al, 2007). In particular, the process of apoptosis in endothelial cells has been linked to be a primary stage in the development of atherosclerosis (Nakano et al., 2006 from D’Ascenzo et al, 2007). In the case of modification of levels of Calcium, an increase in calcium has been linked to apoptosis (Guerini et al., 2005 from D’Ascenzo et al, 2007). The increase in calcium directly acts to increase the permeability of mitochondria which results in the release of factors such as holocytochrome c, apoptosis-inducing factor, and caspase-9 that aid in apoptosis (Achar et al, 2010). Perhaps the most alarming effect of the abuse of steroids has been the increased incidence of sudden death associated with it. This may be an indirect result of the lipoprotein abnormalities which were previously discussed. Oxygen demand may be increased greatly during exercise which may result in a cardiac ischemia. Alternatively, direct mechanism of action ia that steroids can increase the aggregation of platelets and this may lead to the formation of a thrombus. The increase in the aggregation of platelets is brought about by an increase in the production of thromboxane A2 (a platelet aggregator), a decrease in the production of prostacyclin (an inhibitor of platelet aggregation) and an increase in the levels of fibrinogen(Achar et al, 2010). It was seen that in several studies, cardiac causes have been related to death in abusers of steroids with up to two-thirds of death being cardiac related (Achar et al, 2010). It has been mentioned that apoptosis increases due to steroid abuse and this has been linked with sudden cardiac death, myocardial infarction, ventricular remodeling, and cardiomyopathy. These are the ways by which steroid abuse can be fatal without the presence of coronary thrombosis or atherosclerosis (Achar et al, 2010). The second major detrimental characteristic was on hepatic function. Prolonged steroid abuse is undesirable to the liver. Some of the disorders that have been linked with steroid abuse include cholestasis, peliosis hepatis (hepatic cysts containing blood that can rupture) and liver tumors (Socas et al, 2005; Chyka, 2003). While in many cases, these conditions are not life threatening, and most tumors are seen to be benign, it is important to detect them early to prevent development into haemorrhages and malignant degeneration which can be fatal. The tumors were seen to regress after the halt of steroids which did indicate a direct link between the two (Socas et al, 2005). Thirdly, another major detrimental characteristic is effects on reproductive function. In males, feminization may occur with steroids like testosterone being converted to estardiol. This results in a high-pitch voice and gynecomastia. In females, changes such as a deepening of the voice, enlargement of the clitoris and hirsutism may occur. These symptoms will continue to stay on even after the abuse of steroids is halted. In children who abuse steroids can stunt growth and lead to precocious puberty (in boys) or exhibit contrasexual precocity in girls (Chyka, 2003). In addition to the biological effects already described, the fourth and detrimental characteristic is behavioral problems. It must be made mention of that abuse of steroids can even result in several psychiatric disorders. Up to 23% of users of anabolic steroids were reported to suffer from disorders such as mania, hypomania, mood disorders, depression and in general, increased irritability and aggression (Pope and Katz, 1994). In addition, there appears to be a co-relation between adolescent boys who are steroid abusers and risky behavior. It was reported that they are much more like to do things like drinking and driving, having sexual intercourse with a condom or even carrying a gun (Chyka, 2003). In conclusion, it can be said that the abuse of steroids is rampant amongst certain pockets of the population. Though steroids are banned by all sporting bodies, they are generally abused by athletes to increase muscle strength and to enhance performance though adolescents have been reported to abuse steroids too. It is difficult to get an accurate estimate of the number of abusers due to a reluctance to admit it. Steroids, when taken at legal doses that are prescribed for therapeutic reasons, usually do not cause any side effects. When taken at high doses, there may be biological effects to the human body. These effects can be divided into unfavorable effects on cardiovascular, hepatic, reproductive, and behavioural functions. Possible the worst effects are the cardiovascular effects as in the worst case scenario, abuse of steroids may result in death. It is however, very difficult to pinpoint steroids were indeed the cause due to other factors like the use of multiple drugs playing a role. Undesirable hepatic and reproductive functions are usually not life-threatening if they are detected in time. While the effects of hepatic function cease once steroid abuse is stopped, the effects are seen to be more long lasting on reproductive function. Behavioral effects can be undesirable to society as a whole as it results to aggression in some cases. To sum up, it can be said that while the use of steroids provides some desirable short-term effects, the long-term effects can be extremely unpleasant and even fatal. Bibliography Achar, S. Rostamian, A. and Narayan, S.M. (2010). Cardiac and Metabolic Effects of Anabolic- Androgenic Steroid Abuse on Lipids, Blood Pressure, Left Ventricular Dimensions, and Rhythm. The American Journal of Cardiology. 106. Pp 893–901. Chyka, P.A. (2003). Health Risks of Selected Performance-Enhancing Drugs. Journal of Pharmacy Practice. 16 (37). Pp 37-44. D’Ascenzo, S.; Millimaggi, D.; Di Massimo, D.; Saccani-Jotti, G.; Botre, F.; Carta, G.; Tozzi- Ciancarelli, M.G, Pavan, A. and Dolo, V. (2007). Detrimental effects of anabolic steroids on human endothelial cells. Toxicology Letters. 169. Pp 129–136. McEwen, B.S. (1991). Non-genomic and genomic effects of steroids on neural activity.TIPS. 14. Pp 141-147. Pope, H.G.and Katz, D.L. (1994). Psychiatric and Medical Effects of Anabolic-Androgenic Steroid Use. Arch Gen Psychiatry.51. pp 375-382. Socas,L; Zumbado,M; Perez-Luzardo, O; Ramos,A; Perez, C; Herna´ndez,J.R. and Boada, L.D. (2005). Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature. British Journal of Sports Medicine. 39 (27). Read More