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Do anabolic steroids other than testosterone work?

Oliver Zolman MD

· Fitness

Androgenic anabolic steroid (AAS) interventions with effects that are unclear if meaningful

Androstenidone (testosterone precursor) at 300 mg a day for 7 days increased total T by 34%, and total estradiol by 24% on average, in young men (Leder et al., 2000).

Androstenidone taken only for 2 days similarly elevated oestradiol without increasing testosterone (https://www.ncbi.nlm.nih.gov/pubmed/10683601)

A 2007 review on testosterone DHEA, androstenedione, and androstenediol concluded that “ Studies have demonstrated repeatedly that acute and long-term administration of these oral testosterone precursors does not effectively increase serum testosterone levels and fails to produce any significant changes in lean body mass, muscle strength, or performance improvement compared with placebo.” (10.1016/j.pcl.2007.05.002).

Interventions with no meaningful effects

DHEA 100mg/day for 28 days was found to have no effect on exercise performance in athletic women (doi: 10.1055/a-0631-3008).

DHEA 100mg/day for 28 days in young athletic men had no effect on body composition or BMI (https://www.ncbi.nlm.nih.gov/pubmed/21789881)

60 mg prednisone a day for 1 week in young men had no effect on exercise performance (doi: 10.1016/j.steroids.2014.04.008).

60 mg prednisone immediately before cycling endurance exercise caused an increase in time to exhaustion from 45 – 85 minutes to 67 – 147 minutes 95% ranges (10.1136/bjsm.2007.043083).

0.25mg IM synthetic ACTH did not improve acute or subsequent cycling performance in trained cyclists (10.1007/s00421-008-0802-y).

Oral T and 19-norandrostenedione had no effect on exercise performance or serum T in young male athletes (10.1007/s00421-006-0271-0).

General risks to the androgenic steroid class (not all these apply to each drug within the class): copied from 10.4085/1062-6050-47.5.08.

  • 11. Supraphysiologic AAS dosing may occasionally be associated with hypomanic or manic syndromes that are often characterized by irritable or aggressive behavior.21,54,6778 Episodes of major depression may be associated with AAS withdrawal.7981 Abusers of AAS may develop a dependence syndrome related to both myoactive and psychoactive effects8289 and may exhibit other forms of drug dependence, such as opioids.83,9093 Evidence Category: B
  • 12. The cardiovascular effects of therapeutic AAS remain unclear. Substantial research findings now suggest that AAS abuse negatively influences the cardiovascular system.25,67,94103 The best evidence indicates that nontherapeutic AAS-related conditions include cardiomyopathy96,97,99,100and the potential for atherosclerotic vascular disease caused by detrimental lipid changes, which may adversely affect one's risk for coronary artery disease.25,102,103 Evidence Category: B
  • 13. Although rare, hepatic maladies including cholestatic jaundice and peliosis hepatis might occur with the nontherapeutic abuse of AAS, especially when the oral C17α-alkylated group of AAS is involved.7,1114,22,24,51,55,104 Evidence Category: A
  • 14. Exogenous AAS abuse inhibits the hypothalamic-pituitary-gonadal axis, reducing the production of endogenous testosterone, luteinizing hormone, and follicle-stimulating hormone.7,1114,22,51 It can also alter thyroid function11,12,22 and negatively affect glucose tolerance.12,22,105 Evidence Category: B
  • 15. Abuse of AAS directly affects the male reproductive system, with possible side effects including hypogonadism, decreased spermatogenesis, decreased sperm motility, erectile dysfunction, impotence, gynecomastia, and male-pattern baldness.7,1114,22,51,55 Many of these conditions are reversible with cessation of AAS, although breast tissue changes and hair loss often require additional treatments, including surgery.7,1113,22,51,55 Evidence Category: B
  • 16. Reproductive changes to females who abuse AAS generally involve virilization, including voice deepening, hirsutism, clitoral hypertrophy, breast reduction, libido changes, menstrual dysfunction, male-pattern baldness, and acne.1114,22,51 Unlike the side effects in males, many of these changes are permanent in females.12,14,22 Evidence Category: B
  • 17. Skeletally immature AAS abusers might experience premature epiphyseal closure of the long bones, resulting in shortened stature.11,12,14,22,51 Other negative effects of AAS abuse on the musculoskeletal system may include tendinopathies (including possible rupture).7,1113,22,51 Little evidence supports the therapeutic use of AAS for musculotendinous injury recovery.7,106 Evidence Category: C
  • 18. A possible immunosuppressant effect of AAS abuse may exist in humans.11,22,107 Abusers risk local and systemic infections (including hepatitis and human immunodeficiency virus) with unsterile syringe usage.11,12,14,22 Evidence Category: B
  • 19. High-dose AAS abuse often leads to a number of dermatologic conditions, most commonly some form of acne.11,12,14,22,108,109 Kidney structure and function may be at risk with supraphysiologic doses of AAS, especially when combined with use of nonsteroidal anti-inflammatory drugs, high-protein diets, certain nutritional supplements, and dehydration.11,22,51,55,110,111 Gingival and other oral tissues may also be affected.52,112 Evidence Category: C
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