Steroids are often portrayed as the ultimate shortcut for muscle growth and performance enhancement, but what are the real risks ...

the-untold-truth-about-steroid-side-effects-are-they-really-a-big-deal

The Untold Truth About Steroid Side Effects (are they really a big deal?)

people like to use steroids so let's talk about them I'm Dr Rea Malik urologist and pelvic surgeon and today I want to talk about a serious issue and that's steroid use steroids are synthetic versions of the male hormone testosterone and these are often misused by people to enhance muscle growth and performance however this can come at a huge cost to your health now anabolic steroid abuse is a significant Public Health concern studies estimate that about 3.3% of people people worldwide have used anabolic steroids at some point now that sounds like a small number but it's really not and it certainly has higher rates among certain high-risk groups it's estimated that about 30% or so of bodybuilders and athletes use steroids however it's not only them 80% of steroid use is by non-athletes people who just want to enhance their body image so in the general population it's estimated that about 1.3 to 4 million Americans have used anabolic steroids with about 100,000 new users each year and up to 30 to 35% of those users go on to develop a dependence on these drugs and even scarier than that is that a lot of times anabolic steroids are obtained through really unregulated sources 71% get them from somewhere on the internet 24% from gym dealers and 19% from foreign mail orderes and only 11% through prescriptions now the scary part is because there's no regulation you don't know what's actually going in those substances that they're either eating or injecting themselves with and even more so many users will stack multiple steroids on top of them or you sort of pyramid their use and so they're using tons of unregulated substances which all come at a cost now anabolic steroids work because they're absorbed into the bloodstream after either injection or oral ingestion they then travel to the Target tissues where they can bind to Androgen receptors and they can cause changes in gene expression in terms of muscle growth they bind to those receptors in the muscle themselves which then stimulates protein synthesis and muscle growth as well as strength gains ultimately now this allows people to gain muscle significantly faster than someone who's non-enhanced and that can be a very strong pull for some people so there's not a lot of data on use of anabolic steroids one because it's very difficult to get people to enroll in these studies and admit that they're using legal substances and two it's not really safe to do randomized control trials on people with anabolics when we know what some of the negative squ are in 1996 a study was published in the New England Journal of Medicine a very prominent Journal which gave men 600 milligrams of testosterone weekly for 10 weeks now let me give you some scale most people are on somewhere around 100 to 200 milligrams of testosterone per week so this is significantly higher than the average person who's taking testosterone for the purposes of maintaining normal levels so these guys who got 600 Mig gained an average of 6.1 kg of fat-free Mass being lean body mass they also increased their bench press strength by 22% another study in 1999 found that 100 milligrams of none weekly for 6 months gting an average of 4.5 kg of lean body mass now these are some really big gains in a very short period of time however these uses of these high doses of anabolic steroids over long periods of time can have serious consequences it to many body organ systems in fact the risk of heart attack in anabolic steroid users is 15 times higher than the average person and premature death is 122 times more likely in someone using anabolic steroids and in autopsy studies where they look at people who had steroid abuse related deaths they found lots of various patterns of heart damage as well as scarring in the heart and enlargement of the heart heart chambers which is likely causing these premature deaths now let's talk about how steroids can affect the multiple organ systems in your body let's start with the most important the heart and the cardiovascular system so anabolic steroids can cause heart problems because they lead to enlargement of muscles in addition to the muscles in your body they also lead to enlargement of the muscle of the heart particularly the left ventricle and the high testosterone levels that you get when you take steroids can actually cause a narrowing of the blood vessels what we call paradoxical narrowing which then leads to a higher risk of clotting and if you remember my last video on the risks of regular testosterone replacement there is a risk of blood thickening which increases with higher doses putting you at higher risk for blood clots as it is steroids also activate what we call the renin Angiotensin aldosterone system and this system is important for maintaining healthy blood pressure fluid balance and electrolyte balance so taking these steroids of ultimately can lead to increased blood pressure it also impairs CC autonomic regulation this means that you're not getting the signals to maintain your normal heart rhythm so you can get abnormal heart rhythms and they negatively impact cholesterol levels particularly causing then the risk of ethos sclerosis or buildup of plaque and heart attack next up liver so liver is more common when you're taking oral anabolic steroids particularly those that are what we call 17 Alpha alkal these can lead to liver toxicity other liver conditions and even liver tumors next up the reproductive system anabolic steroids will suppress the body's natural production of testosterone and sperm this will lead to testic shrinkage for one but it will also lead to infertility now what about low libido and erectile dysfunction if you're increasing testosterone that shouldn't be an issue right so one research team went out to look at exactly what happened they surveyed 231 anabolic steroid users to identify what issues they were having in terms of sex while they were taking high doses and long durations of anabolic steroids they did have have good erectile functioning during use but as soon as they stop they had higher rates of new onset erectile dysfunction and decrease libido after stopping in particular those who use them more frequently and for longer periods of time were more likely to experience these sexual side effects and so think about it right when you're on these really high doses your body gets used to a certain set point and that set point will be having significant lots of erections really high libido and once you take those away even if you appear normal meaning you want to have sex every day and you have firm erections they're just not the same as they used to be and this can then lead to a lot of distress and feeling stress and then ultimately having difficulty with erections and low libido what about brain so high doses of anabolic steroids have been linked to mood disorders aggression anxiety and impulsivity this is more common in those who develop a dependence on these steroids they're actually seeing in this group that they are brain changes on MRI specifically they're seeing a thinner cortex in many areas including the prefrontal cortex which is the front of the brain that's involved in inhibitory control and emotional regulation and this is what's likely contributing to aggressive behavior and as I mentioned when you stop using these medications you can go through sort of a withdrawal because you have a new set point and this withdrawal can then not only lead to those sexual issues we talked about but also depression and other psychological issues what about your kidneys so chronic use can also contribute to the development of kidney disease this can be through a combination of the increased muscle mass as well as the direct Toxic effect of anabolic steroids on the kidney to Wheels themselves also sometimes you can become injured more easily this is because when you have this increased muscle mass and strength from steroid use you can then put excessive strain on your tendons which leads to higher risks of tendon ruptures and injuries and the steroids themselves can disrupt the normal architecture and remodeling of those tendons further increasing the chances of tendon damage ultimately this can lead to chronic pain and that's even worse when you go off the steroids that can then become sort of a slippery slope where you're Now using pain medications or abusing those pain medications as well as using anabolic steroids because while you're on those anabolic steroids you can push yourself so much further you can get something serious called rabdomiolisis This is a condition where those damaged muscles fibers release their contents into the bloodstream causing kidney failure and even send you to the hospital and just like taking regular testost Replacements people can experience acne and hair loss interestingly sometimes you may be at higher risk of infection because steroids can cause an immunosuppressive effect and you may end up sharing needles with other people than putting yourself at higher risk for blood rated infections and lastly there are real Financial consequences to maintaining that steroid use if you're doing using it over years and years and years it can become very costly and people can start doing all sorts of things to be able to maintain that steroid use I made this video because I can understand why people end up starting using steroids it can be very attractive to people who want to optimize their body image and very often now more and more we're seeing even young men teenagers starting to use steroids in fact Jesse James West just made a video about this Jeff niord made an excellent video about steroid use Mike isrel has talked about it openly so check out their channels check out their videos I think they're super helpful but ultimately I think it's really important that as doctors we talk about this openly and that if you come to your doctor you shouldn't be afraid to talk to your doctor about this because it's important that you get blood work done that you get evaluate you make sure you are healthy and safe and you're not harming yourself and help you get off these medications safely and effectively I hope you guys found this informative and helpful if you are new here make sure to check out as well my podcast which is available on all podcast platform forms and share it with your friends and family I think it's really wonderful to be able to sit down with experts from all around the world and learn from them and share that with you guys so as always I'm going to take care of yourself because you are worth it

Dr.

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