Anabolic steroids (or steroids for short) are man-made substances similar to the male sex hormone testosterone that promote the growth of skeletal muscle and sexual development in both male and females ( National Institute on Drug Abuse, 2022). Peptides and steroids are both Performance enhancing drugs (PED), but their similarities end there. They differ greatly when it comes down to how these substances act in our body; namely because peptides are naturally occurring while anabolic steroids have been manufactured through chemical means such as synthesis (Tech, 2021).

Anabolic steroids are a class C controlled drug under the Misuse of Drugs Act 1971 which can only be sold by pharmacists with prescriptions. They’re legal to have for personal use, but importing or exporting them is illegal if you’re believed to supply or sell them – including giving your friends these drugs! The penalty includes an unlimited fine AND prison time up 14 years long sentence (UK Anti-Doping, 2020).

CARDIOVASCULAR DISEASE- How does it link with anabolic steroids and peptides?

A study showed that the use of anabolic steroids can narrow the coronary arteries and impair left ventricular function. Together, these effects reduce oxygenated blood flow to your heart as well from the heart to the arteries (Baggish, Weiner, Kanayama, Hudson, Lu, Hoffman and Pope, 2017). Another study found that there was significantly more plaque build-up in the arteries of steroid users than non-users, a huge sign of heart disease (Perry,Schuetz, Memon,Faiz and Cancarevic, 2020).

Increasing food consumption, especially meat and protein in your diet is very common in regular gym-goers, athletes or anyone trying to build muscle and fuel their workouts. However, this high calorie diet, on top of anabolic steroids and peptides can worsen the risk of cardiovascular disease. The problem with saturated fats is that they can increase your cholesterol levels, which then can increase the risk of heart disease (Briggs, Petersen and Kris-Etherton, 2017).

 

RISK OF CANCER?

The use of peptides stimulates the release of human growth hormone, which plays and important role in muscle and bone growth (Boulder Longevity Institute, 2019). In the world of sports, peptides have become a popular alternative to steroids as they are a more natural substitute. They can be absorbed much quicker and will not show up on tests as easily.

The risk of cancer arises as GH can induce the generation and regulation of insulin-like growth factor 1 (IGF-1) which promotes cancer development by stimulating cell proliferation (Shanmugalingam, Bosco, Ridley and Van Hemelrijk, 2016).

That’s why although peptides seem safer than anabolic steroids because they are naturally formed, they still pose great danger if used inappropriately.

 

WHAT HAPPENS IF YOU STILL TAKE ANABOLIC STEROIDS AT A YOUNG AGE?

Taking anabolic steroids at a young age can cause hormonal imbalance as the natural hormonal cycle of your body is disrupted. Due to this, there are not only dangerous physical changes but also psychological changes as the brain development is impaired (National Institute on Drug Abuse, 2022)

 

So why is their use continued?

 

According to the 2017 Image and Performance Enhancing Drugs (IPED) Survey, these were the predominant reasons users took steroids (UK Anti-Doping, n.d.).

 

• Improving body image/ cosmetic reasons – 56%
• Non-competitive bodybuilding – 45%
• Enhancing sports performance – 27%

 

Sadly, despite the plentiful evidence of their harmful effects, the attitudes towards anabolic steroids and peptides are still wrong. Some athletes and professionals feel that because there are so many risk associated with them, the right to use them needs to be earned. They believe that this is achieved by working hard towards reaching your physical goals naturally first, and then if the goals aren’t met, the use of these drugs is justified since you have earned the right by working hard. Does that mean just because someone earns the right to take these illegal drugs they are less dangerous? The answer’s clearly no and therefore more awareness needs to be spread still in order for people to protect people from these harmful drugs.

 

Here’s one such example: https://www.instagram.com/p/CZdGqjyJICD/

 

Is there a safe way of using still using them?

 

The steroids and peptides you take can have a significant impact on your health and overall well-being. The best way to stay safe is not use anabolic steroids at all, but if you’re considering using them to increase muscle mass or improve athletic performance, some steps can be taken reduce the negative impact on your health or help detect health issues caused by the side effects at early stages.

 

• REGULAR BLOOD TESTING

 

Testing regularly can help to monitor the above markers to ensure that health stays optimum and adverse effects are screened. You should aim to test the bloods every three months or especially after a course. Below are the main markers to monitor although, different medications, could cause different markers to change.

 

Red blood cell count

Testosterone or its modified derivatives are one of the main anabolic steroids. Their overuse has been shown to cause erythrocytosis (increased concentration of red blood cells in your blood) making the blood thicker and increasing the risk of clots and other serious conditions (Bachman et al., 2014; Cervi and Balitsky, 2017).

 

Lipid Profile

Although more evidence is needed to confirm the findings, high doses of testosterone has been linked with raising LDL (“bad”) cholesterol levels and lowering HDL cholesterol levels (Harvard Health, 2010). A major risk factor for cardiovascular disease.

 

C-reactive protein (CRP) levels

 Aids in diagnosing inflammation in the arteries to predict cardiovascular risks (Ghantous et al.,2020)

 

Liver function tests

 

Anabolic steroid use has been shown to cause liver injury and chronic liver problems (Niedfeldt, 2018; Alén, 1985). Steroid use results in elevations of enzymes in the liver which cause hepatoxicity (chemical-driven liver damage) and therefore it is essential to check the levels of the following; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as well as gamma-glutamyltranspeptidase (GGT), and creatine kinase (CK) levels. CK and GGT tests help eliminate natural causes of the spike of serum enzymes such as excessive exercise may cause their levels to rise (Dickerman et al., 1999).

 

IGF-1 Test

 

Since the use of steroids promotes IGF-1 production greatly increases the risk of many types of cancers as mentioned above, it is important to make sure the levels stay within range.

 

Although these tests may be indicative of the side effects, a normal blood test may not always necessarily mean you are safe and clear of health issues.

 

Summary

The dangers of performing enhancing drugs including anabolic steroids and peptides are well documented and their classification as class C controlled drugs highlight the extent of harm they may cause. Despite that their use is still continued. It is important to make an informed decision by knowing the consequences these drugs have both physiologically and psychologically on the body and the risks of diseases such as cancer and cardiovascular diseases before deciding to take them. By keeping the dangers and laws in mind, if they still are taken, it is essential to monitor the markers regularly to ensure adverse effects are screened.

 

 

References:

• Alén, M. (1985). Androgenic steroid effects on liver and red cells. British Journal of Sports Medicine, [online] 19(1), pp.15–20. Available at: https://bjsm.bmj.com/content/19/1/15.short [Accessed 2 Apr. 2022].
• Bachman, E., Travison, T.G., Basaria, S., Davda, M.N., Guo, W., Li, M., Connor Westfall, J., Bae, H., Gordeuk, V. and Bhasin, S. (2014). Testosterone Induces Erythrocytosis via Increased Erythropoietin and Suppressed Hepcidin: Evidence for a New Erythropoietin/Hemoglobin Set Point. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
• Baggish, A., Weiner, R., Kanayama, G., Hudson, J., Lu, M., Hoffmann, U. and Pope, H., 2017. Cardiovascular Toxicity of Illicit Anabolic-Androgenic Steroid Use. Circulation, 135(21), pp.1991-2002 Börjesson, A., Ekebergh, M., Dahl, M., Ekström, L., Lehtihet, M. and Vicente, V., 2021. Women’s Experiences of Using Anabolic Androgenic Steroids. Frontiers in Sports and Active Living, 3.
• Boulder Longevity Institute. (2019). Peptide vs Steroids: Straight Talk. [online] Available at: https://boulderlongevity.com/peptide-vs-steroids-straight-talk/ [Accessed 24 Mar. 2022].
• Briggs, M., Petersen, K. and Kris-Etherton, P. (2017). Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk. Healthcare, 5(2), p.29.
• Cervi, A. and Balitsky, A.K. (2017). Testosterone use causing erythrocytosis. Canadian Medical Association Journal, [online] 189(41), pp.E1286–E1288. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647167/ [Accessed 28 Mar. 2022].
• ‌ Dickerman, R.D., Pertusi, R.M., Zachariah, N.Y., Dufour, D.R. and McConathy, W.J. (1999). Anabolic steroid-induced hepatotoxicity: is it overstated? Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine, [online] 9(1), pp.34–39.
• Harvard Health. (2010). Testosterone and the heart. [online] Available at: https://www.health.harvard.edu/heart-health/testosterone-and-the-heart#:~:text=Testosterone%20and%20cardiac%20risk%20factors [Accessed 2 Apr. 2022].
• National Institute on Drug Abuse. 2022. What are the different types of APEDs? | National Institute on Drug Abuse. [online]
• NIDA for Teens. 2021. Anabolic Steroids Drug Facts, Effects, Use | NIDA for Teens. [online] Available at: <https://teens.drugabuse.gov/drug-facts/steroids-anabolic> [Accessed 30 March 2022].
• Niedfeldt, M.W. (2018). Anabolic Steroid Effect on the Liver. Current Sports Medicine Reports, [online] 17(3), pp.97–102. Available at: https://pubmed.ncbi.nlm.nih.gov/29521706/.
• Perry, J., Schuetz, T., Memon, M., Faiz, S. and Cancarevic, I., 2020. Anabolic Steroids and Cardiovascular Outcomes: The Controversy. Cureus,.
• Shanmugalingam, T., Bosco, C., Ridley, A.J. and Van Hemelrijck, M. (2016). Is there a role for IGF-1 in the development of second primary cancers? Cancer Medicine, [online] 5(11), pp.3353–3367. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5119990/.
• Tech, A.C. (2021). What Is the Difference Between Peptides and Steroids?[online] Advanced ChemTech. Available at: https://www.advancedchemtech.com/what-is-the-difference-between-peptides-and steroids/#:~:text=Peptides%20and%20steroids%20are%20both [Accessed 23 Mar. 2022].
• UK Anti-Doping. 2020. Fast facts about steroids | UK Anti-Doping. [online] Available at: <https://www.ukad.org.uk/fast-facts-about-steroids> [Accessed 30 March 2022]