Examining the Safety of Anabolic Steroids

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Anabolic steroids are a group of natural and synthetic steroid hormones that promote muscle growth and strength. An example of a natural anabolic steroid is testosterone. Synthetic steroids include nandrolone, stanozolol, oxymetholone, fluoxymesterone, and trenbolone.

Steroids are usually injected, but oral forms are used as well. Particularly in bodybuilding, synthetic and natural steroids are used to enhance size and performance. This practice is mostly illegal and also defies competition regulations.

The use and abuse of steroids, even with dubious safety protocols such as cycling and avoidance of oral steroids, can lead to significant health problems -- and rare fatalities, usually from cardiovascular complications. ("Cycling" is the practice of stopping use for several weeks within, say, a 10-week period.) Although different steroids and their routes of administration--injection, by mouth or even inhalation have different adverse effects--there is no doubt that in various circumstances anabolic steroids cause adverse liver, kidney, sexual and reproductive, cardiovascular, and mood effects.

Cycling steroids or injecting them (rather than taking them by mouth) does not protect against all adverse effects. Below, you can see actual medical case reports of various serious effects of steroid use.

Case 1. Clenbuterol and the Cardiovascular System

A 31-year-old man came to the emergency department approximately 30 minutes after taking clenbuterol syrup. He had a heart rate of 254 beats per minute (tachycardia), and this remained high until he was treated appropriately.

Case 2. Steroids and Stroke

A 26-year-old male amateur athlete suffered an ischemic stroke (blockage of a brain artery). His only significant risk factor was non-medical use of stanozolol.

Case 3. Persistent Loss of Testosterone (Hypogonadism)

In this case, testosterone production did not return after steroid use was ceased, leading to infertility and complete (primary) testicular failure and impotence, which includes loss of testosterone and shrinkage of testicles.

Case 4. Acute Kidney Injury from Anabolic Steroids

Two men, ages 21 and 30, came to the emergency department with abdominal pain, nausea, and vomiting. They reported using anabolic steroids and veterinary supplements.

Case 5. Cardiomyopathy, Blood Clots, and Acute Liver Failure in a Bodybuilder

A previously healthy 40-year-old bodybuilder, suspected of having toxic hepatitis (liver damage) associated with anabolic steroid abuse, was admitted to the hospital. Despite the absence of symptoms and signs of congestive heart failure when he was admitted, an anabolic steroid-induced cardiomyopathy (heart muscle disease) with a large blood clot in both heart chambers was found to be associated with the liver injury.

Case 6. Anabolic Steroids Impair Right Heart Chamber Function

It is well established that chronic use of anabolic steroids suppresses function of the left ventricle (left heart chamber). However, a 2009 study shows that steroid-using bodybuilders have smaller diastolic velocities of both ventricles than drug-free bodybuilders and sedentary counterparts.

Case 7. Liver Tumors in Steroid-Using Bodybuilders

Two quite different cases of adult male bodybuilders who developed liver tumors (adenomas) following steroid use are reported.

The appropriate strategy for clean bodybuilders and sports people alike is, naturally, good diet and hard work.

8 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute on Drug Abuse. Anabolic Steroids DrugFacts.

  2. Daubert GP, Mabasa VH, Leung VW, Aaron C. Acute clenbuterol overdose resulting in supraventricular tachycardia and atrial fibrillation. J Med Toxicol. 2007;3(2):56-60. doi:10.1007/BF03160909

  3. Santamarina RD, Besocke AG, Romano LM, Ioli PL, Gonorazky SE. Ischemic stroke related to anabolic abuse. Clin Neuropharmacol. 2008 Mar-Apr;31(2):80-5. doi:10.1097/WNF.0b013e3180ed4485

  4. Boregowda K, Joels L, Stephens JW, Price DE. Persistent primary hypogonadism associated with anabolic steroid abuse. Fertil Steril. 2011 Jul;96(1):e7-8. doi:10.1016/j.fertnstert.2011.04.029

  5. Daher EF, Silva Júnior GB, Queiroz AL, et al. Acute kidney injury due to anabolic steroid and vitamin supplement abuse: report of two cases and a literature review. Int Urol Nephrol. 2009;41(3):717-23. doi:10.1007/s11255-009-9571-8

  6. Bispo M, Valente A, Maldonado R, et al. Anabolic steroid-induced cardiomyopathy underlying acute liver failure in a young bodybuilder. World J Gastroenterol. 2009 Jun 21;15(23):2920-2. 4. doi:10.3748/wjg.15.2920

  7. Kasikcioglu E, Oflaz H, Umman B, Bugra Z. Androgenic anabolic steroids also impair right ventricular function. Int J Cardiol. 2009;134(1):123-5. doi:10.1016/j.ijcard.2007.12.027

  8. Socas L, Zumbado M, Pérez-Luzardo O, et al. Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature. Br J Sports Med. 2005;39(5):e27. doi:10.1136/bjsm.2004.013599

By Paul Rogers
Paul Rogers is a personal trainer with experience in a wide range of sports, including track, triathlon, marathon, hockey, tennis, and baseball.