Anabolic Steroids – safety and risk mitigation
The use of anabolic steroids is increasing globally, with use rising the fastest in the UK and Europe. More than one million people in the UK use anabolic steroids, though this figure may well be an underestimate. Most people are likely aware that use of anabolic steroids carries health risks, but may not be clear on the exact damage that using anabolic steroids can cause or how to mitigate these risks.
What are anabolic steroids
Anabolic-androgenic steroids (AAS) are a group of hormones (which can be natural or synthetic) which promote the building of skeletal muscle. The most common anabolic steroid is testosterone, which is produced in the body naturally but can be taken on top of the body’s natural supply.
Another option that some people may consider is the use of SARMs (Selective Androgen Receptor Modulators). Unlike anabolic steroids, these compounds are legal and can be purchased from some supplement shops. However, this does not make them safe. Many of these compounds have had relatively little research done into their potential side effects, especially long-term, and caution is advised.
How are anabolic steroids taken?
Some anabolic steroids, such as testosterone, are injected into the muscle (commonly the gluteus maximus, or buttocks). Other AAS, such as Anadrol, are taken orally. Some people who use AAS choose to combine more than one type of steroid in order to increase the effects.
What are the risks and how can I make them safer?
It is beyond the scope of this article to discuss every potential side effect of the various AAS available. For further information please see the ‘further reading’ section below.
Hepatoxicity (damage to the liver) is observed with all anabolic steroids, but the damage to the liver is more severe when using oral steroids. This is largely due to the slower clearance from the liver. The most common effects include elevated liver enzymes (these are proteins which speed up chemical reactions in the body), bland cholestasis and, in rare cases, tumours in the liver. Elevated liver enzymes are typically harmless, but when present without the use of anabolic steroids they may be a sign of disease, and it is possible that the use of anabolic steroids could prevent the disease being noticed at the earliest stages. Bland cholestasis is characterised by nausea, fatigue, dark urine and jaundice. If you experience these symptoms, use of steroids should be discontinued immediately. Tumours are a rare, but serious, side effect of AAS use. They typically appear after several years of using anabolic steroids.
AAS have also been shown to damage the heart, with increased risk of heart disease and arrhythmia (an irregular heartbeat). This damage appears to be reversible with the discontinuation of AAS.
The use of AAS has been shown to reduce the natural production of testosterone in people who have used the drugs. This can make it challenging to come off the drugs long-term, as it is harder to build muscle after discontinuing use.
There is potential for kidney damage occurring from the use of AAS. This includes scarring of the kidneys and reduced ability of the kidneys to filter waste. In extreme cases, kidney failure may occur, requiring dialysis. However, due to the typical combination of anabolic steroids and high protein diets (sometimes as high as 500g of protein per day) it can be difficult to separate the harms from steroids and the damage caused by excessive protein intake.
Menstrual cycle disturbances can occur in women due to the change in hormone balance, and in men the use of anabolic steroids can cause a decrease in sperm count and mobility.
Steroids can also cause aesthetic changes, such as increased acne and swelling from fluid retention.
How to stay safe using anabolic steroids
If you do decide to use AAS, or are currently using them, it is important to be vigilant to the potential harms.
It is a good idea to speak to your doctor about AAS use, and to get regular blood work done. Some cities have clinics set up for people using anabolic steroids and performance enhancing drugs. These clinics can provide tailored harm reduction advice to suit your specific needs, sterile injecting equipment and blood tests to check hormone levels, cholesterol levels and kidney and liver function tests.
Test your drugs: counterfeit drugs are everywhere, and can be very difficult to spot. Whilst EZ Tests do not offer a specific test for anabolic steroids, it is always a good idea to test your drugs to ensure that they do not contain any particularly dangerous drugs that you do not intend to take. One study found that 10 out of 19 samples tested did not contain any anabolic steroids, and those that did contain anabolic steroids ranged from 0.09 to 119,228.57 mg/kg, suggesting that even where anabolic steroids are confirmed the dose and safety are far from guaranteed. There have even been samples analysed by WEDINOS where recreational drugs like ketamine and dihydrocodeine were detected instead of anabolic steroids.
Learn about the steroids you are taking: there are a great many different anabolic steroids available today. Some of them, like testosterone and metandienone (Dianabol) are well studied and the risks and harms are well known. Other anabolic steroids have been developed much more recently, and have relatively little known about their efficacy or safety. Stick to the well known and widely researched options if you plan to use anabolic steroids, especially if you do not have experience with steroids in the past.
Start low, go slow: it is much better to find that you did not take enough your first time round than find that you have taken too much and are experiencing lots of side effects. If you feel like you need to, you can always increase your dose in the future.
Increase your weights slowly. Tendon damage may be more common in people who use anabolic steroids. While the exact cause is not known, it may be partially due to the muscles growing faster than the tendons can keep up, leading to excess strain on the tendons while lifting. To reduce this risk, it may be a good idea to work up through the weights slowly, rather than lifting the heaviest weight you can every time you go to the gym.
If you are injecting: injecting drugs carries its own risks, including infection and blood borne diseases. Never share needles, and always use sterile injecting equipment.
Further reading
Steroid use trends in Britain and Europe
How many people in the UK use steroids?
Anabolic steroid use among gym-goers in Europe
The growth of anabolic steroid use
What are anabolic steroids
What are the risks of anabolic steroids
The effect of anabolic steroids on the liver
Harms of anabolic steroids to the liver
Decrease in natural testosterone production following anabolic steroid use
Kidney damage from anabolic steroid use
Harm reduction