Clinical use of anabolic steroids
Androgenic-anabolic steroids (AAS) are implemented through the network of pharmacies by prescription in almost every country. This group of drugs are used for a long time with a variety of medical purposes in different age groups. In some cases, the clinical use steroids to maintain life. This fact justifies judgments about the harmful effects of drugs on the human body. In this section we discuss some of the many pathological conditions where AAS applied.
Hormone-replacement therapy. Treatment of hypogonadism
Steroids are often prescribed as replacement therapy in testosterone deficiency in the body man. Otherwise, this type of treatment is called hormone replacement therapy or testosteronzamestitelnaya ( HRT, the HRT ). The meaning of this treatment comprising administering testosterone in the body. Patients are most often men in middle age older than 30 years. In addition, hypogonadism ( low levels of male hormones ) causes the irreversible aging process.
Symptoms of low testosterone levels:
- decreased sex drive,
- violation of erectile function,
- decrease in muscle mass,
- unexplainable mood swings,
- . decrease in physical endurance, etc.Such manifestations of hypogonadism in older men are designated by the term – “andropause.” About late hypogonadism experts say that the level of testosterone in the blood plasma is below the permissible limits at a rate of 200ng / dl to 350 ng / dL . Some experts believe the lower the permissible norm of 200 ng / dL . Hypogonadism is currently poorly diagnosed. Specialists pay little attention to the low rate of testosterone, if a man makes no complaints.
Substitution therapy with hormonal therapy eliminates the manifestation of symptoms that indicate a low level of testosterone. Initiated treatment will raise the concentration of testosterone to normal levels, which will certainly affect the recovery of sexual function in men. Treatment of a positive effect on bone density. For example, research it has been found that if taking the drug containing testosterone for three weeks, the bone density is increased by 5%, which significantly reduces the risk of fracture.
- increases the concentration of red blood cells (RBCs);
- markedly improves the general well-being;
- effect on endurance;
- It helps to increase muscle mass.Replacement therapy in the elderly improves the condition of the heart and blood vessels, as well as a positive effect on cholesterol concentrations, in particular on the ratio of HDL to LDL. Men begin to lose weight. In diabetes the glucose level in normal plasma. All these factors have a positive effect on atherosclerosis warning. HRT has a positive effect on the concentration of inflammatory markers in the blood: tumor-necrosis factor (ONF), interleukin – alpha (IL-1) and Interleukin – 10 (IL – 10). As a consequence, a marked decrease inflammation of the inner lining of blood vessels, thus prevented the formation of scar tissue. It is now established that hormone replacement therapy does not adversely affect the occurrence of diseases of the cardiovascular system. Some patients have markedly reduced the risk of pathologies of the system. For elderly patients receiving the testosterone can produce some undesirable effects . The prostate may increase in volume and prostate specific antigen in the blood increases (PSA). Testosterone has a stimulating effect on the growth of benign and malignant tumors of the prostate. That is why the hormone is contraindicated in the stronger sex with a tendency or a history of these diseases. In healthy men, this side effect does not occur. Another undesirable effect – apnea ( in sleep apnea ). In fact, on this occasion still blown controversy, as there is no precise evidence to support the link between sleep apnea with receiving androgens. HRT, depending on the dose received may have different effects on cognitive function in elderly men. The level of testosterone within the normal range has a positive impact, improving the function of cognition.
Possible supplementation with HRT
Through the skin ( transderamalny ) in the form of a gel or by sticking plaster – a common method of administration of testosterone in the clinics of America and Canada, which has a number of advantages:
- no pain provides psychological comfort;
- a constant concentration of testosterone without strong vibrations that occur when administered intravenously. The most common drug dosage per day – 2.5 – 10 mg. But the introduction of the drug in this manner may increase dihydrotestosterone concentration in blood plasma that contributes to androgenic side effects. That is why in some cases it is necessary to resort to the injection mode of administration.With the help of injections in the United States and Canada entered testosterone cypionate or enanthate testosterone . Other countries specialists prescribe testosterone in a drugs ” Sustanon 100 ” or ” Sustanon 250 “. Only one injection at 14-21 days of the drug provides a desired level of hormones in the blood, which, depending on the time of administration may vary. The maximum concentration of hormone in the blood in the first days after administration. Over time, towards the end of the third week of the hormone level will gradually decrease. The US practice of imposing prolonged form of testosterone, which is produced in the form undecanoate (nebido). Its introduction is approved in clinics of other states. The clear advantage of the drug – a multiplicity of administration. The year is enough 4-5 injections in order to maintain the necessary concentration of testosterone in the blood.
The oral route of administration is not allowed in the US, but sold in pharmacies in Canada and in many other states. The only drug in tablet form containing testosterone – a ” Andriol ” ( testosterone undecanoate ). The oral route of administration characterized by maximum comfort for the patient. It is enough to take a day designated expert dosage of the drug in capsule form before meals and the necessary level of hormones in the blood is contained. Begin taking the drug with a dosage of 120-160 mg ( it is up to 4 capsules that are taken in the morning and evening ). In the following days, the dosage is reduced to 120 mg a day – thus ensuring maintenance therapy. The disadvantage of this mode of administration is the fluctuation levels of testosterone in the blood throughout the day. For better digestibility drug necessary to use at least 20 g of food containing fat. A feature of this method of administration, as well as the admission of the drug through the skin is to increase blood plasma dihydrotestosterone levels, which can lead to the appearance of a number of adverse reactions.
In order to frolic relief of allergic reaction in the form of hereditary angioedema – a rare, potentially dangerous condition for life, anabolic steroids are used. The reason is closely related disease with genetic mutations in certain blood coagulation factors which lead to a deficiency of C1 – inhibitor of complement system. It, in turn, is involved in controlling the inflammatory response. Hereditary angioedema is manifested rapid swelling of the tongue, throat, mouth and other mucous membranes, hands, feet. In addition, the swollen bodies of the gastrointestinal tract, which leads to cramps in the abdomen, nausea and vomiting. Severe manifestations of edema is a complete asphyxia due to the overlap of the respiratory system, asthma and death. Seizures are not always trigger allergens. In some cases, mechanical injury, medical interventions lead to edema.
Oral steroids with 17-alpha alkylation reliably protects people from sudden, severe to life and limb edema attacks, so it is recommended to take a preventive purpose. The preparations take a long time, starting with a small dosage. In America, the most frequently prescribed:. “Danazol”, “stanazolol” “Oxandrolone” “Methandrostenolone”, etc. The minimum therapeutic dose of the selected expert based on many factors. Age, weight, concomitant diseases, etc. FDA recommends using stanazolol three times a day 2 mg on reception. Dose should be gradually reduced to 24-48 mg per 2 hours to prevent side effects.
Red blood cells are red blood cells are formed under the influence of erythropoietin, which is synthesized in the kidney. The direct impact on its active generation have AAC. Owing to such effects of steroids increases the number of erythrocytes and the level of hematocrit, which was successfully used in the treatment of certain forms of anemia. Steroid-sensitive forms of anemia include:
- anemia arising in patients with renal insufficiency;
- aplastic anemia;
- anemia resulting from exposure myelotoxic or toxic substances;
- . myelofibrosis, etc.Efficacy of hormonal drugs is dependent on various factors: the shape of the disease, the patient’s age, type of therapy and others.
In most cases, the treatment fails to achieve a good therapeutic effect ( increase in red blood cells, hemoglobin, hematocrit ). In America, for this purpose use ” Oxymetholone ” ” Nandrolone Decanoate “. The dose of drugs ( in particular oxymetholone ) does not depend on the sex, age and weight of: to 1 kg designed to 2 mg of the drug. For an adult with an average weight of 70 kg the dose is 150 mg . Sometimes the doctor decides to increase the dose to 5 mg per 1 kg of body weight to achieve the desired therapeutic effect. Nandrolone Decanoate assigned differently: women to 100 mg , and men to 200 mg per week. Children aged 2 to 13 years is assigned to 50 mg once a month. Recently there have been changes in treatment regimens anemia, are associated with the advent of recombinant erythropoietin. But if the drug does not necessary expected therapeutic effect, the expert may be appointed AAS. The downside of steroids are the side effects that are manifested in children and women. It is because they preferred the new drugs, the use of which does not cause significant adverse effects.
After removing the purpose of treating breast cancer, during extinction of reproductive function, as well as after removal of the ovaries in women as replacement therapy may be assigned to agents by AAS. Especially they will be effective, if a cancer is hormone-dependent, and further growth of the tumor can be braked by external hormones. Androgens and estrogens have opposite effects on tumor formation. Thus, estrogens favor the growth of breast tumors, and androgens, conversely, have a depressing effect. Changes in the androgen-estrogen ratio is influenced by steroid effective for many patients. But parallel to have a therapeutic effect may be adverse influence. With great care should be carried out treatment of breast cancer in women, male sex hormones as possible manifestation of the masculinizing side effects.
For the treatment of extensive use flyuksimesteron and nandrolone decanoate. The first drug given greater preference, since the treatment of side effects can be interrupted.
Recently, instead AAS for treating breast cancer are increasingly using new anti-estrogen drugs, aromatase inhibitors and selective estrogen receptor modulators. Currently, cancer is treatable drug called ‘ Nolvadex ‘. It is used in combination with an aromatase inhibitor ( ‘Arimidex’, ‘Femara ” ).
AAS in America can still be used to treat breast cancer. And often they are used at a time when treatment is one antiestrogen drugs ineffective.
The decrease of fibrinolytic activity
-Androgenic anabolic steroids are used to treat blood coagulation abnormalities in the system, in particular to reduce fibrinolitcheskoy activity. What it is? Blood, due to its constituent factors, it coagulates and breaks down blood clots formed. The latter process is called fibrinolysis. Together, these two phenomena are opposite hemostatic balance. Disturbances in this system leads to serious consequences.
The result is a decrease in fibrinolytic activity hypercoagulation ( excessive blood clotting ) that can lead to heart attack, stroke, thromboembolism. Use of 17-alpha alkylated AAS as tablets increases fibrinolytic activity that becomes useful for patients suffering from pathologies associated with that antithrombin III deficiency or excess fibrinogen. For the treatment of this disease in the United States used the ” Stenozolol “. The dosage was adjusted physician taking into account individual characteristics of each patient. Preparations in the form of injection , and tableted unalkylated AAS not demonstrate significant fibrinolytic effect.
Several less AAS drugs are prescribed for the treatment of male infertility. Androgens may contribute to an increase in sperm concentration, change the quality and the number of Leydig cells. All these factors lead to an increase in the chance to conceive a child. For this purpose, a drug called ” Proviron® ” in the form of tablets, despite the fact that it did not approve for use in America. This is due primarily to the fact that AAS affect the decrease in male fertility.
Problems with increasing
The growth of the child is under the influence of the hormone somatotropin. Steroid drugs favorably influence the growth of bone and muscle mass. That is why AAS prescribed to children to solve the problem of low growth. They are appointed as growth zones are still open, but linear growth has stopped. During this period the impact of AAS can favorably affect the increase in growth. Changing the size of the long bones can occur by direct anabolic effects on cells, but also indirectly by the activation of IGF – 1 and growth hormone. With this purpose non-aromatizing steroids.
Treatment is carried out under the supervision and with great care, so as steroids, in addition to the usual side effects may affect the acceleration of the closure of the epiphyses. In America, the drug “is used for this purpose Oxandrolone .” It stimulates growth and hubbub taken a period of up to one year. Dosage chosen physician in view of many factors from the patient:. Weight, sex, age, etc. The usual dosage of 2.5 mg per day . The result of successful treatment can be a significant leap in growth compared with the period before treatment. But many studies regarding this drug, did not confirm its effect on the patient’s growth. What is not in doubt, since it is in the short-term increase in growth that was observed while taking AAS.
At menopause there is a decrease of female sexual desire. In America, in order to eliminate this problem in women, as well as the other manifestations of menopause drug “assigned methyltestosterone .” Its small doses are part of estrogenic drugs. The dosage of the drug is less than 2 mg per day .
Vacuum bone ( osteoporosis ), which affects mostly older patients successfully treated using steroids. The benefits of this therapy is to enhance bone formation, better absorption of calcium and stop further bone loss. One of the symptoms of osteoporosis – bone pain. The drugs significantly reduce its manifestation. Since osteoporosis more often encountered in postmenopausal women, which is due to taking place in the field of hormonal changes. Another reason, which leads to osteoporosis, long-term treatment with corticosteroids. Under their influence, there is resorption ( vacuum ) and inhibition of the formation of new bone tissue. This type of pathology is called glucocorticoid osteoporosis.
Increase bone density and reduce the likelihood of fractures possible with nandrolone decanoate. For postmenopausal women is provided in dosage of 50 mg . The drug should be used during the month. To noticeable side effects of the treatment include: giperholesterenemiya ( increased cholesterol in the blood ) and virilization ( excessive growth of hair on different parts of the body, change in voice tone ). Less noticeable side effects, these drugs if treatment is carried out in individuals who are older than 65 years. Men assigned medication for 50 mg every 7-14 days . The therapeutic effect is maintained long-term use of the drug for between six months and more. Only regular, long reception of funds would make the bone stronger.
In America, about the efficacy of this drug against osteoporosis expert opinions are mixed. Most health organizations commented on the prevalence of adverse therapeutic effects. So, today, on the FDA does not recommend nandrolone as the primary means for the treatment of osteoporosis. In order to reduce pain in osteoporosis using oxandrolone. He was not appointed as an agent, wagging an increase in bone density. In medical institutions of other states anabolic steroids are widely used in the complex treatment of osteoporosis.
Turner’s syndrome and Klinefelter’s syndrome
AAC can be used for the treatment of diseases transmitted at the genetic level. Among them partially amenable to therapy known Klinefelter syndrome, common in men and Turner syndrome, which manifests itself in women. These pathologies are associated with deviations from normal chromosomes XX or XY. For men with this syndrome tend flabby physique, they have underdeveloped genitals ( mikroorhizm – small testes ), which leads to infertility, breast cancer (over-developed gynecomastia ). With this patient prescribers AAS, with which you can affect sexual function and change the constitution.
Turner Syndrome brings to the physical development of women are numerous deviations, among which: the deformation ears, characteristic folds of skin in the neck, low growth, expansion of the chest, shaped like a barrel, the low line of hair growth. Support the growth rate slightly change the physical parameters is possible with the help of the combined effects of growth hormone and anabolic steroids. In America, for this purpose specialists use ” Oxandrolone ” at a dose of 1 mg per kg body weight per day .
Losing weight and muscle mass
Significant loss of muscle mass well to treatment by AAS.
For some reason there is a decrease in muscle mass? Prolonged treatment with hormonal therapy ( such as corticosteroids ), major trauma, surgery, infectious diseases, prolonged bed rest with a lack of adequate load on the muscle tissue.
Secondary loss of muscle mass can be and extensive burns. AAC will be useful, and the sudden weight loss to a state of cachexia, for no apparent reason. It is proved that the mortality rate is high among people who are underweight. Recovery after surgery or myocardial disease is largely due to the human body’s ability to maintain optimal weight. Significant weight loss can be avoided by steroid drugs, which have a positive effect on protein synthesis. A good therapeutic effect will be noticeable if the patient has no contraindications and no cross-responsiveness with other medicines.
Anabolic drugs are universal, therefore have a positive effect on muscle mass and bone. U.S. combat the loss of body weight are required using the drug named ” Oxandrolone “. It is administered in the morning and evening for 10 mg . In order to prevent manifestations of androgen effects women, the elderly, patients at a young age are assigned the lowest dosage. The drug is administered in the period of active recovery during one month. If necessary, the duration of his appointment may be extended. The clinics in other countries applies not only to ” Oxandrolone “, but drugs such as: ” Methandrostenolone “, ” Stanozolol “, ” Methenolone “, ” Nandrolone “.
During prolonged cachexia ( exhaustion ) muscle fibers lose protein, and with it the weight, vigor and strength. Cachexia often accompanies diseases such as HIV and various cancers. Anabolic steroids are appointed experts in certain diseases, followed by exhaustion. The use of AAS in cachexia in patients with cancer remains unresolved. In America, in HIV-infected severe malnutrition is treated with drugs such as nandrolone decanoate, oxandrolone and oksimetalon.
FDA does not clearly indicate the feasibility of introducing these drugs, but the case studies confirm that nandrolone decanoate, introduced at a dose of 150 mg every 2 weeks has the same effect as introduced into the body 18 IU GH . It is noted less manifestation of side effects. In 2003, ” Oxymetholone ” was successful next phase III clinical trial in HIV-infected patients. In the study used the same dosage (100-150 mg per day), some experts recommend a destination for a long time. Recently, “Oxandrolone” is used more often than nandrolone decanoate in the treatment of cachexia in HIV-positive, as the drug has a high level of comfort. It is administered in a dosage of 20-80 mg per day. The best therapeutic effect was seen in the appointment of the drug is in the therapeutic range.
As you can see, the terrible and horrible anabolics are no drugs or poison. This is a medication that can help solve certain health issues. However, the use of steroids in high dosages in order to increase muscle mass ensures a set of side-effects . We do not recommend risking your health for the sake of extra centimeters to your biceps.