Anabolic-androgenic steroids: Uses, common brands, and safety info

Hormones are our body’s natural messengers, telling the cells of our body what to do depending on our current situation. Anabolic hormones tell body tissues to grow bigger and stronger. Natural examples of anabolic hormones include testosterone and growth hormone. The hormone testosterone is a steroid variety of hormone that produces both anabolic and androgenic effects. The androgenic effects are responsible for male characteristics like facial and body hair and deepening of the voice.

Testosterone deficiency can cause several health problems. For example, a male child with insufficient testosterone may not grow and develop in a typical fashion during puberty. An adult may recognize a progressive loss of muscle mass and sex drive when testosterone levels have fallen. Medical anabolic-androgenic steroid replacement can be life-changing for anyone with testosterone deficiency. Unfortunately, the medical versions can also be misused as appearance or performance-enhancing drugs. The following article will address the uses and misuses of anabolic steroids, their side effects, and their sizable costs.

Other anabolic-androgenic steroids

• Nandrolone

• Stanozolol

• Striant

• Androstenedione

What are anabolic-androgenic steroids?

Anabolic hormones tell our body tissues to grow in size and strength. Bone and muscle are principal tissue types that respond to this directive. Steroids are a natural body substance; they consist of a particular structure (a 17 carbon atom ring), and one of their functions is to serve as hormones. Putting these terms together, testosterone is an anabolic steroid hormone. Fortunately, it can be made synthetically in order to be given therapeutically for medical use. 

The anabolic steroids nandrolone and stanozolol are similar to testosterone and have been developed to mimic testosterone’s effects on muscle growth. These drugs and testosterone can be inappropriately used by athletes to gain a competitive advantage or by individuals without testosterone deficiency who are seeking a leaner, stronger physique. DHEA and androstenedione supplements have been touted to have these effects because they are converted to testosterone in the body. These steroid uses have led many athletic organizations to ban the use of steroids. In addition, the Drug Enforcement Agency has classified testosterone and androstenedione as controlled substances.

Testosterone and these related compounds are also androgens. They are termed anabolic-androgenic steroids (AAS) because of this dual function. Androgens promote male physical characteristics, such as facial hair and body hair growth, and a deep voice. Androgens can also lead to acne and male breast growth, as they do during puberty. By comparison, growth hormone and its synthetic version, Zomacton, are anabolic hormones, but they do not have the androgen effect or steroid structure.

How do anabolic-androgenic steroids work?

The anabolic and androgenic actions of testosterone are carried out on multiple different body tissues. Protein synthesis is stimulated within muscles, causing them to become stronger. Bone will be strengthened over a period of time as well. Within the skin, androgens cause thickening and an increase in sebum oil production, a result of which can be acne. The prostate can also become enlarged. Some testosterone is converted to estrogen by the body, which explains the potential for breast enlargement in men.

Other effects of anabolic-androgenic steroid use have been described within the bloodstream, potentially increasing red blood cell concentrations or clotting tendency. The cardiovascular system may also be impacted by steroids. Good cholesterol (HDL) and bad cholesterol (LDL) levels may be reduced. The potential for testosterone therapy to cause an increased risk of heart attack is a concern that is being investigated. 

Testosterone is a male sex hormone that’s produced in the testicles. Psychological benefits, such as improved energy, mood, and sex drive, may occur during testosterone therapy. 

Testosterone therapy must be closely monitored, so that normal blood levels are achieved and maintained. An excessive amount can exacerbate the potential for adverse effects. For example, cardiomyopathy, a dangerous heart condition, may occur. Concern exists for possible heightened aggression as well, the so-called “roid rage.”

What are anabolic-androgenic steroids used for?

Androgens and anabolic steroids are approved for the following medical conditions:

• Male hypogonadism, also known as low testosterone or “low T”

• Constitutional delay of growth and puberty

• Multiple pituitary hormone deficiencies

Types of anabolic-androgenic steroids

Injectable forms

Depo-testosterone and testosterone enanthate are injected into muscle tissue. Xyosted is injected under the skin. Injections are done every one to two weeks. Dosing is adjusted based on blood level results and may need to be modified if side effects are experienced. Aveed (testosterone undecanoate injection) is an oil-based formulation that only needs to be injected every four to 10 weeks, but due to risks related to the oil, it has limited availability.

Topical forms

Androgel, Testim, Fortesta, and Vogelxo are testosterone products that are applied to the skin. Your hands should be immediately washed after applying, and children should not be allowed to touch the site of application. Androderm is a patch form of testosterone. The topical products are reapplied daily. Testosterone blood levels need to be checked in order to properly adjust dosing.

Oral forms

Jatenzo is an oral form of testosterone undecanoate. Striant is a testosterone product that is placed between the gums and lips. These oral forms are taken twice daily. Dosing is based on ongoing blood test results for testosterone.

Who can take anabolic-androgenic steroids?

Can men take anabolic-androgenic steroids?

Men with symptoms related to abnormally low testosterone are appropriate candidates for possible testosterone therapy.

Can women take anabolic-androgenic steroids?

There are currently no recommended treatment guidelines or FDA-approved testosterone products for women. Potential uses are being studied.

Can children take anabolic-androgenic steroids?

Adolescent males with deficient levels of testosterone can take testosterone. Some products are approved for use in adolescents older than 12 years old, and others are approved for use over age 18.

Can seniors take anabolic-androgenic steroids?

Testosterone levels normally decline as men age. Normal aging can sometimes entail changes similar to the symptoms of low testosterone, such as reduced energy, strength, or sex drive. Based on the difficulty in determining if symptoms are caused by low testosterone and due to their potential for health risks, the use of testosterone replacement in older men is controversial.

Are anabolic-androgenic steroids safe?

Black box warnings

• The FDA has placed its highest warning on topical testosterone gels related to their risk for secondary exposure to children who touch the product. 

• Xyosted and Jatenzo contain a black box warning about the risk of elevated blood pressure and the cardiovascular complications of blood pressure elevation. 

• This level of warning also exists for Aveed injections, because of the potential for damaging microscopic oil droplets to travel to the lung through the bloodstream.

Recalls

No active recalls are currently in place for testosterone products, but the FDA’s database can be searched for the most up-to-date listings.

Restrictions

• Androgens and anabolic steroids should not be used if you have had a prior hypersensitivity allergic reaction to the products, their relatives, or the other ingredients within the product. 

• Breast or prostate cancer are also reasons to avoid these steroids. 

• Additionally, anyone with diabetes, obesity, enlarged prostate, high red blood cell counts, high calcium levels, sleep apnea, or a history of lung, heart, kidney, or liver disease should be particularly cautioned about testosterone use. 

• Men who are trying to conceive need to be warned about infertility risks.

Can you take anabolic-androgenic steroids while pregnant or breastfeeding?

These products should not be used while pregnant or breastfeeding. Currently, there are no FDA-approved uses in women.

Are anabolic-androgenic steroids controlled substances?

The DEA does list these products as controlled substances. Anabolic steroid abuse can lead to dependency. Athletes, bodybuilders, and weightlifters may also use these drugs in excess for muscle-building. Anabolic steroids are a form of doping, a term used for taking substances to improve athletic performance. These steroid users may use pyramiding, a technique where they start with low doses then gradually increase to high doses before decreasing the dose back down. With prolonged drug use, the body’s natural mechanisms for testosterone production can be blunted temporarily, so withdrawal symptoms can occur. 

Common anabolic-androgenic steroid side effects

The following are some common side effects across androgens and anabolic steroids:

• High blood pressure, leg swelling, or cholesterol changes

• Prostate enlargement, prolonged erection, urinary difficulty, or PSA test elevation

• Mood swings, libido changes, irritability, fatigue, or insomnia

• Gynecomastia (male breast enlargement)

• Headache or numbness

• Diarrhea, vomiting, or nausea

• Hair loss (male pattern baldness), rash, or acne

• Abdominal or joint pain

• Polycythemia (elevated red blood cell counts)

• Sleep apnea

Less common side effects include heart attack, stroke, blood clots, prostate cancer, liver cancer, liver damage, aggression, or low sperm counts.

How much do anabolic-androgenic steroids cost?

The SingleCare discount card can be beneficial to those needing a prescribed testosterone replacement product. The savings could help to reduce the high retail costs of injectable testosterone, which can cost more than $200 per month, or topical testosterone, which can cost nearly $600.