Anabolic Androgenic Steroids

History of steroid use

* Use in 1953 Olympics for weightlifting
* Side effects became an issue
* Widely used in the 1960s
* 1980s - use spread to amateur and school sport
* Law passes so only on prescription
* Steroid use now banned

Chemical characteristics of steroids

* Structures of commonly abused anabolic steroids, many based on testosterone

Physical characteristics and dosage

* Taken orally or intramuscularlly
* Athletes + sprinters = low dose
* Bodybuilders = 100x therapeutic dose
* Liver metabolises to fast for oral steroids to act sometimes

What is stacking?

Stacking - use more than one at a time (more effective)

What is cycled?

* Taken for 6-12 weeks than abstain
* Minimises tolerance
* Reduces side effects
* Maximises perfromance
* Avoids detection

What is pyramiding?

* Increase dose gradually to midpoint of a usage cycle and then decrease again


* Reduces withdrawal

What are physical effects of steroids?

* Anabolic - increase muscle size, mass, strength
* Androgenic - masculinising properties
* Therapeutically

Bhasin et al. (2001) - effects on testosterone

* Healthy men 18-35, prior weightlifting experience, but hadn't taken steroids
* Given monthly treatments of testosterone, with another drug to suppress endogenous testosterone
* 20-50 mg doses → testosterone levels below baseline
* 125-mg dose → testosterone at baseline 300 and 600mg dose → testosterone 2-4 times baseline
* (All anabolic steroids either contain testosterone, or are testosterone derivatives)

Mechanism of steroids: steroids act at androgen receptors

* Androgen receptors present in cytoplasm of skeletal muscle
* Androgens bind + activate receptor → which moves to cell nucleus and regulates DNA transcription of specific genes
* Androgen receptor activation increases protein synthesis and muscle growth

What is a problem for this hypothesis?

Normally androgen receptors are already saturated so how can steroids work on them?

Alternative hypotheseses

* Hypothesis 2: steroid treatment induces receptor expression in muscle
* Hypothesis 3: androgens are antagonists for glucocorticoid hormones - which are catabolic: decrease protein synthesis, increase in protein breakdown

Side effects

* Converted in some tissues to dihydrotestosterone (DHT) by 5a-reductase
* Has androgenic effects
* Converted to estradiol by aromatase (aromatisation)
* Normal process, mediating testosterone effects on CNS
* Feminising effects
* Increase irritability and aggression

Pope et al. (2000) - side effects

* 84% almost no change
* 12% mild mania
* 4% strong mania

Textbook side effects

* Some common (e.g. acne) others rare (peliosis hepatitis)
* Many reversible (e.g. cardiovascular effects)
* Some not (e.g. masculinising effects on women; stunted growth in younger users due to premature closing of epiphyses at the end of long bones)
* Which side effects occur depend on age, sex of user, steroid type, dose, pattern and duration of use

Evidence of addiction reported by steroid users

* take more than intended
* can't cut down even though want to
* spend much time obtaining and using
* continue use despite problems use causes
* replace other activities with substance use

Withdrawal symptoms of steroids

fatigue, depression, insomnia, restlessness, anorexia, decreased libido, dissatisfaction with body image, desire for more steroids …

Reinforcement of steroids - laboratory studies

* Systemic testosterone and testosterone in nucleus accumbens both produce a conditioned place preference in mice
* Nucleus accumbens is a neural substrate of reward
* The place preference is reversed by the D1/D2 antagonist a-flupenthixol (not chemically related to testosterone)
* Perhaps rewarding due to effect on body image

Legal issues

* Class C drugs to be sold only on prescription
* Illegal for personal use
* Importation or exportation only legal in person
* Possession/importing with intent to supply = 14 years + unlimited fine

Social issues

* 2007 - 200,000 people in Uk have tried them
* 42,000 in the past year
* Increasing use in boys 12 and 13