Are all steroids bad?

"No way I want that shot, cortisone is a steroid," some athletes may say. That's true, but this is no reason to avoid this powerful and usually effective anti-inflammatory drug. The truth is there are good steroids and there are bad steroids.

Steroids are a big class of chemical compounds that all have the same basic geometrical structure. Some steroids occur naturally, and others are synthetic. Some steroids are widely used in medicine (although they may need to be used with caution). Then there are the bad guys, banned for use in athletic competition.

The "good" guys

Some of the good guys are made in your body; for example, sex hormones. In women, estrogens control female sexual characteristics. They trigger breast development and initiate menstrual cycles in girls, and also control the stages of women's periodic cycles.

In boys, testosterone causes development of deeper voice and beard hair, and greater muscle development and higher red blood cell count in men, compared to women.

Other places you find good steroids are in bile acids and Vitamin D compounds. Birth control pills are steroids.

During and after menopause estrogen levels drop, and this can interfere with calcium metabolism and contribute to osteoporosis, and also be associated with hot and cold flashes, fatigue and weakness, and sometimes depression. These symptoms are commonly countered by hormone replacement therapy, and some women receive steroid therapy for long periods.

Men experience lower testosterone levels with age. This doesn't usually drop low enough to cause problems, but if older men experience a lower sex drive, testosterone injections occasionally may be prescribed.

Anti-inflammatory drugs
Many steroids are excellent anti-inflammatory drugs. We've already referred to cortisone, which is a natural product because your body produces some in response to stress. Cortisone, and some synthetic steroids, such as Kenalog, may be injected into some injury sites. Most doctors inject only one or two doses, because repeated cortisone injections can break down connective tissues over long periods.

There are some valuable steroid anti-inflammatory drugs for allergy and asthma patients. Products such as Nasalide and Nasacort shrink swollen nasal tissues, and products such as Beclovent and Aerobid shrink bronchial tubes that are swollen and causing asthma.

A powerful anti-inflammatory drug used to treat allergic inflammations and arthritis is called prednisone, and is taken by mouth. This drug is usually for allergy and asthma patients when the topical products don't work, for arthritis patients when non-steroidal drugs fail to give relief and is part of some cancer chemotherapy treatments. Unfortunately, long-term prednisone tends to suppress the production of natural steroids in your body, and can lead to weight gain, glucose intolerance, ulcers, thin skin and bruising, osteoporosis, muscle weakness, and weakened immunity. It is therefore usually given for short periods, or on alternate days.

The "bad" guys

The bad guys are called anabolic steroids. The word anabolic in medicine means promotes building, and sports use is to promote muscle building, and sometimes to speed rebuilding of injured tissues. Testosterone promotes muscle building naturally, but if you inject more you can cause additional muscle building. This is illegal in sports. There are many relatives of testosterone that build muscle, some injectable and some can be taken by mouth. They have names such as steranobol, danabol, oranobol, anadrol, and many others.

They work, so they give unfair advantage; they are banned. However, they have a whole list of adverse side effects in men, including increase in sex drive and aggression (is this why violent crime by college athletes is on the increase?), breast growth, acne, lower HDL cholesterol, and damage to testes, prostate, and kidney. They also cause problems in women, including body hair growth, deeper voice, abnormal menstrual cycles and changes in sex organs.

Conclusion

The story on steroids, then, is that you can safely follow the recommendations of your doctor for use of a variety of anti-inflammatory drugs for injuries, and allergy and asthma treatment. You need to remember, though, that they are powerful drugs with significant side effects if they are not used strictly according to the manufacturer's guidelines and doctor's instructions.

Stay away from unauthorized anabolic steroid use to build muscle or heal injuries. Apart from the fact that they are illegal in sports, they can cause a heck of a lot of damage when used for long periods.

Copyright The American Running Association