Hello everyone and welcome back. In this section we begin to discuss steroids and their effects. Let's begin by going to slide two.

As we can see here, steroids were developed in the late 1930's for hypogonadism. That is basically caused by a lack of testosterone produced by the testes. It was used to treat delayed puberty, impotence, and what we call body wasting syndrome.

However, there was a side effect; this is shown on slide three. Basically, what the researchers found was that there was an increase growth of skeletal muscle. Consequently, it began being used be bodybuilders and other athletes to increase their muscle mass. Ultimately, this has influenced a wide variety of many sports outcomes and consequently is banned by many sports organizations.

There is a wide variety of reasons for the use of steroids and some of these are listed in slide four. Of course, it has been used to increase sports performance and extensively used by bodybuilders. It causes an increase in body mass resulting in increased strength. It also helps to reduce body fat and while this drug was initially used for sports performance or protection because you needed to be stronger, etc. Today, a lot of people use them just to make themselves look more attractive and to improve athletic performance as well.

There is a wide variety of Anabolic Steroids and as we can see in slide five, there are basically over a hundred types. Most are very similar in structure and the major differences occur in relation to the metabolic degradation by the liver. There are two major groups that people usually take, and that relates to the oral and the injectable types.

Oral steroids are listed in slide six while injectable steroids are listed in slide seven.

In addition, we have a wide variety of dietary supplements which are shown in slide eight. Some people believe they also have anabolic steroidal effects and are designed to be converted into testosterone or similar effects. These are what we call the precursors. They can often be purchased without a prescription and include drugs such as Andro and DHEA.

There are three major effects of steroids, anticatabolic effects, anabolic effects, and motivational effects. So let's talk about each of these for a minute.

Anticatabolic effects are shown on slide ten and what they do is block the action of natural cortisone. Cortisone functions to increase energy stores during stress and training. They break down proteins to their amino acids. If you get too much cortisone, you get muscle wasting. So too much of a workout is actually bad for you.

Steroids block this process and as we can see in slide eleven, it may be one of the reasons for the development of body mass.

Anabolic effects are shown in slide twelve. These basically follow the synthesis of a new protein in muscle cells. This also causes a steroidal release of endogenous growth hormone. The problem is the doses used by athletes are ten to two hundred times more than the therapeutic dosage for normal testosterone deficiency.

As a result you get all sorts of effects. Consequently, you need to stack or pyramid several types of drugs to get the desired effect you are wanting. Often time’s users will combine oral and injectable substances through either cycles of weeks or months of duration.

The motivational effects as we see in slide fourteen are huge. Individuals begin to get the shape they are wanting and they also develop a more aggressive personality. This is commonly called Roid Rage. Ultimately, both of these can be beneficial in sports involving strength and combativeness such as football.

In females, steroids also have an effect and basically as we see in slide fifteen they exert the same effects as in males and they induce female masculinizing effects. These include increased body hair, enlarged clitoris, coarser skin, voice changes, and even menstrual cycle cessation or irregularity.

When the woman ceases use as seen in slide sixteen the results are variable, often there is an incomplete return of the functions after stopping and many of the side effects continue to occur.

There are really two ways to get steroids into the system. As we can see in slide seventeen, one can either take pills or use injection. With injection this drug is given intramuscularly and in the gluteus maximus which is in your butt. Usually, individuals use clean needles so needle sharing is not as common as with other drugs that are out there.

When one consumes the drug orally as we see in slide eighteen, it is absorbed into the intestine. It immediately goes to the liver where it is metabolized. And as a result of this metabolization minimal amounts actually increase the systemic circulation to reach the brain.

Injectable, on the other hand, get around this process because it does not go into the liver. As we can see in slide nineteen more gets into circulation before being metabolized by the liver and this improves the effectiveness of administration of the particular dose.

So let's describe what happens normally. As we can see in slide twenty, when testosterone levels are decreased it is sensed by receptors in the hypothalamus which then begins producing Gonadotropin-Releasing Factor (/GRF/). /GRF/ circulates in the blood and ultimately goes to the Pituitary Gland.

Once the gets to the pituitary as we see in slide twenty-one, it causes Follicle-Stimulating Hormone (FSH) to be released in females and Luteinizing Hormone (LH) to be released in males. Both of these then act on the reproductive systems of the person. In males what it does is act on the testes to induce the production of sperm and cause synthesis and release of testosterone.

As testosterone levels increase as we see in slide twenty-two, the hypothalamus decreases the production of gonadotrophin-releasing factor you get reductions of FSH and LH. The testes decrease production and the process repeats itself.

What happens when you introduce steroids? As you can see in slide twenty-three it overwhelms the system. What occurs is that you get high levels of these in the system and this causes a decrease in the natural production of the related compounds that we discussed earlier. So what you ultimately get in males is a reduction of testosterone and a decrease in spermatogenesis.

The results of this usage are shown in slide twenty-four. What you get is a decrease in the size of a variety of different structures including the Thymus, spleen, lymph glands, adrenal glands and many others all of which are involved with the immune system functioning.

Finally, as we can see in slide twenty-five, it basically blocks the normal process that regulates testosterone and that reduces male fertility and sperm production. It also exerts a wide variety of peripheral hormonal effects to increase muscle mass giving a more masculine appearance and as a result increased aggression.

Pharmacodynamically, as seen in slide twenty-six, compounds bind on very specific receptor binding sites. These cause the nerve cells to either fire or the structures to secrete a variety of hormones.

Downregulation also occurs with this substance. Downregulation occurs when too much of a substance binds on a receptor site. This causes fewer receptors to developed or made. Over time these receptors become fewer and fewer so consequently you need more of the drug to get the same effect. These effects occur in the testes so consequently you need to increase the steroid level.

The problem is as we see in slide twenty-eight, as you increase your levels it begins to shutdown the hypothalamus. Of course, you will get less production of hormonal release, less stimulation of testosterone, and on, and on, and on, and the process needs to continue.

There is a wide variety of side effects that occur from steroidal use; the first of this is shown in slide thirty.

Basically, it occurs in the brain. It changes the size of the soma in the cell body. It also causes changes in the volume of some of the brain structures such as the hypothalamus.

It also causes a variety of changes in the musculoskeletal structures. As you can see in slide thirty-one you do get an increase in muscle mass, not an issue. However, you also get tendon degeneration so consequently you increase the risk of tendon tears. If you begin to use these drugs too early you get premature closure of bony growth centers. You basically stop growing. You may look good but are shorter than you may have normally been.

There is also a wide variety of liver effects and these are shown in slide thirty-two. You get increased liver enzymes, you get jaundice which is a yellowing of the skin and in the eyes, and you can also develop a wide variety of body tumors. Some which can be fatal. You can also get a type of hepatitis although it is very rare it can occur as well.

Steroids also have a wide variety of cardiovascular effects and some of these are shown in slide thirty-three. All steroids decrease good cholesterol (HDL) and increase bad cholesterol (LDL). Consequently, you get hypertension, increase plaques in arteries which can relate to strokes and heart attacks.

Steroids also have effects on the reproductive system. As you can see on slide thirty-four you have a reduction of testosterone and this causes a decrease in the size of the gonads, and for males you get abnormal spermatogenesis, infertility, and even testicular atrophy. There is a decreased libido and even impotence. Finally, males can even experience painful urination, enlarged prostate and many other things. Fortunately, these are often reversible when use stops. However, there are other side effects that are more permanent.

In females as we see in slide thirty-five, there are a wide variety of other effects. Some of these we have discussed before. For many females you also get smaller breasts, and often you have problems getting pregnant and possibly have problems with offspring if you are using while you are pregnant. Fortunately, many of these are reversible.

Gynocomastia, as seen in slide thirty-six, is the enlargement of the breasts in males. This is the side effect of steroids being metabolized because they are converted to Estradiol.

There is also a wide variety of other side effects, some of which are shown in slide thirty-seven. For example, there is a decreased immune response to a wide variety of different substances, so you are going to get sick more often. There is also a decreased structure going on within the thyroid so you are going to have problems with thyroid functions. So you may actually get fat. Acne also occurs and there is also an acceleration of male pattern baldness.

Psychologically as seen in slide thirty-eight, there is a wide variety of problems that can occur as well. Yes, you can get euphoria; in fact it actually can increase your addiction potential. There are also increased risks of habituation and tolerance which we have talked about before. Often those taking steroids experience great mood swings or even mania. And as we've talked about earlier increased aggression and even psychotic episodes. Finally, individuals who are taking steroids may become more depressed and commit suicide.

In general, as seen in slide thirty-nine, a person develops a Jekyll and Hyde personality when they are using steroids on a consistent basis. This is a very common occurrence and even a slight provocation can cause exaggerated, violent, and often uncontrolled responses. Fortunately all of these are reversible if one stops taking the drug.

There are other psychological syndromes that can occur as well. Some of these are shown on slide forty. These include things such as paranoid jealousy, delusions, and feelings of invincibility. You may also get euphoria, sexual arousal but forgetfulness and confusion as well.

So what happens if a person stops using steroids? As we can see in slide forty-one you get withdrawal syndromes, often times the individual becomes clinically depressed, there is a decrease in sexual desire, fatigue, etc., just like other drugs.

So in conclusion when you talk about steroids, as we see in slide forty-two, steroids are not the fun things people make them out to be. They are very bad and have many side effects. They can also be extremely dangerous and cause lots and lots of problems.

Well that concludes this section. We look forward to talking with you soon and we hope you have a great day.

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