What Are Steroids and When Should They Be Used?
Steroids are a hot topic amongst the media, athletes and the public. Doping scandals and horror stories featuring disturbing side effects make them a fascinating subject, but behind the headlines is a lot of confusion about what steroids are, and which steroids are a real concern in athletics.
There are far more steroids than I could possible cover in a single blog, but in this blog I’m going to outline the differences between the two steroid families – anabolic steroids and corticosteroids – and why they are relevant to health, sport performance and physiotherapy.
What are anabolic steroids?
The steroid that most people think of when they hear about steroids are anabolic steroids, which are a synthetic version of testosterone.
Medically, anabolic steroids are used when the body is unable to produce the correct amount of testosterone or to reduce the rate of muscle wasting.
It’s their non-medical use which makes anabolic steroids controversial. Anabolic means “to build”, which is exactly what anabolic steroids do to your muscle mass.
Due to their muscle building qualities, anabolic steroids are widely used and abused amongst bodybuilders and other athletes. The use of anabolic steroids is an open secret in bodybuilding competitions, while they’re strictly banned in professional athletics.
What are the risks of taking anabolic steroids?
Anabolic steroids aren’t only notorious for the unfair physical advantage they give to athletes who take them, but also the serious negative side effects from abusing them.
In men, anabolic steroids reduce the need for testosterone to be produced naturally, resulting in testicular shrinkage. They also increase cholesterol to dangerous levels, increase risk of heart disease, result in outbreaks of acne and severe, aggressive mood swings.
What are corticosteroids?
Corticosteroids are hormones naturally produced by the adrenal glands, or synthetically produced as an anti-inflammatory medicine or immune system suppressor.
They’re used to treat a wide variety of conditions, such as asthma and allergic reactions. Corticosteroids also reduce inflammation, so they can be an important part of injury rehabilitation in certain injuries.
Of course, athletes need to return to peak performance as soon as possible, so they often take corticosteroids as part of their rehabilitation.
Unlike anabolic steroids, there aren’t as many doping concerns for the use of corticosteroids, and so long as athletes receive a medical exemption they can be used during competition.
Corticosteroids can be used in the long term as a “preventer” (such as in an asthma inhaler) or in the short term to reduce a specific inflammation (such as spinal or joint injections).
Corticosteroids are catabolic, the opposite of anabolic, meaning that with long term use they can break down tissue and led to the development of a variety of diseases, such as osteoporosis (thinning bone), and loss of muscle bulk.
Why have corticosteroids caused scandal in Tour de France?
You may assume that, as they break down tissue, corticosteroids would be avoided by athletes unless they were completely necessary.
However, a dose of corticosteroids also provides significant short term benefits for endurance athletes. As a highly effective anti-inflammatory, they reduce the rate of muscle swelling and soreness, as well is increasing the rate that sugar is delivered to your muscles and reducing fatigue.
If you follow Tour de France, you will have heard news of Bradley Wiggins using Triamcinolone, a corticosteroid ostensibly used to reduce pollen allergies.
However, there are concerns that the pollen allergy was simply an excuse to enjoy the performance enhancing effects of the corticosteroids.
Team Sky has insisted they were only used to treat allergies for which they had a medical exemption.
Suspicions have been raised with many other elite cyclists, who all seem to have severe asthma requiring exemptions for the use of corticosteroids.
The verdict is still out on whether corticosteroids are being used legitimately in cycling while the World Anti-Doping Agency investigates.
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