From the Guidelines
Steroid use can lead to numerous negative health consequences, including serious cardiovascular problems, liver damage, hormonal disruption, and psychological effects, as evident from the most recent study published in 2020 1.
Key Health Consequences
- Cardiovascular problems: heart attacks, strokes, and dangerous blood clots due to increased blood pressure, cholesterol changes, and enlarged heart muscle
- Liver damage: ranging from elevated enzymes to potentially fatal tumors or cysts
- Hormonal disruption: testicular shrinkage, reduced sperm count, gynecomastia, and baldness in men, and masculine traits like deepened voice, facial hair, and menstrual irregularities in women
- Psychological effects: mood swings, aggression, depression, and potential addiction
Additional Risks
- Weakened immune system and increased infection risk
- Musculoskeletal problems like tendon ruptures
- Long-term use of corticosteroids can lead to weight gain, diabetes, osteoporosis, cataracts, and adrenal suppression
Evidence-Based Recommendation
Based on the most recent and highest quality study published in 2020 1, it is clear that steroid use can have severe and long-lasting negative health consequences, and therefore, it is essential to approach steroid use with caution and carefully weigh the potential benefits against the risks.
Important Considerations
- The evidence review graded the evidence on mortality as low certainty, but pooled analysis of 12 studies showed fewer deaths among patients treated with testosterone than those who received placebo 1
- Testosterone treatment improved vitality and fatigue, but the evidence is limited, and more research is needed to fully understand the effects of steroid use on overall health and well-being 1
From the Research
Negative Health Consequences of Steroid Use
- Hepatotoxicity, which can manifest as elevated liver transaminases, acute cholestatic syndrome, chronic vascular injury, hepatic tumors, and toxicant-associated fatty liver disease 2
- Increased risk of cardiovascular disease, including plaque formation, vascular calcification, thrombosis, and coronary artery disease 3
- Pathological fibrosis, dilated cardiomyopathy, heart failure, fatal ventricular arrhythmias, acute myocardial infarction, and reduced ejection fraction 3
- Cognitive decline, memory impairment, and depression due to the effects of steroids on the brain 3
- Testicular atrophy, temporary suppression of spermatogenesis, hypogonadism, reduced fertility, infertility, and hormonal imbalance in male athletes 3
- Ovarian dysfunction and menstrual irregularities in female athletes 3
- Increased inflammatory cytokines, fibrosis, renal tubular hypertrophy, glomerular changes, and structural damage in the kidneys 3
- Skin problems such as acne, gynecomastia, prostatitis, and alopecia 3
- Acne, gynaecomastia, and erectile dysfunction, which affect more than 10% of androgenic anabolic steroid users 4
- Increased risk of mortality and morbidity, with a three times higher mortality rate amongst users of androgenic anabolic steroids than amongst nonuser controls 4
- Side effects such as hypertension, dyslipidemia, testosterone deficiency, and cardiomyopathy 5