Anabolic Steroids vs. Cortisone Injections

There is often confusion about steroids. We hear about steroids taken by athletes as being bad, but we also hear good things about steroids injected for arthritis, or inhaled for asthmatics. What's the difference between the steroids that are taken by athletes to enhance performance, and the steroids prescribed by a healthcare provider?

What Are Steroids?

Essentially, all steroids are chemicals that share some basic components of their molecular structure. But steroids are a broad class of molecules, and different steroids have very different properties.

The most common steroids include anabolic steroids, sex hormones, corticosteroids, and cholesterol. You need not be a scientist to understand that these compounds have very different properties, and these are just the steroids found in mammals; insects, plants, and fungi also have their own characteristic steroid molecules.

What Are Anabolic Steroids?

Anabolic steroids, synthetic substances that are derivatives of testosterone, are the substance most people reference when they use the word "steroids." This type of steroid stimulates the body to convert proteins into muscle tissue, so it's known for its prominent effect of building muscle when taken during athletic training.

Anabolic steroids can be taken by mouth or injected into the body; the duration of effect depends on the type of steroid administered. Athletes often take anabolic steroids to build muscle and help stimulate muscle repair and recovery after activity.

Anabolic steroids are sometimes administered for non-athletic purposes. Some medical conditions warrant anabolic steroid use, including growth problems in children and adolescents, some types of tumors, muscle-wasting diseases (such as HIV/AIDS), and most recently the increased use of testosterone for aging.

What Are Corticosteroids (Cortisone)?

Corticosteroids are medications that have effects on inflammation in the body. Inflammation is a process known as a 'cascade of events.' This cascade means that, for inflammation to develop, a series of events take place. Corticosteroids have effects on a specific step in that cascade of events, stopping the process, and, therefore, reducing inflammation.

Corticosteroids can also be taken orally, injected into a specific area, injected into the bloodstream, or inhaled. To limit side effects, local injections are most often preferred. But if the inflammation is more severe or widespread, systemic steroids may be required.

Corticosteroids can be used for many medical conditions that cause inflammation. Injected corticosteroids, often called cortisone shots, are often used for arthritis, tendonitis, and bursitis. Systemic steroids may be used for conditions including asthma, multiple sclerosis, lupus, and many other problems.

Side Effects

One of the most concerning aspects of steroids—both anabolic steroids and corticosteroids—is the possibility of side effects. Both types of medications have side effects, although they are very different.

Many people who use anabolic steroids have severe acne, premature baldness, and in men, shrinking testicles. There are also potentially fatal complications associated with liver damage and heart enlargement.

Corticosteroids can also cause many side effects although they are different from those of anabolic steroids. Common side effects of cortisone shots include flushing of the face, elevated blood sugar, weight gain, mood swings, muscle weakness, blurred vision, and bruising, among others.

It is possible but not likely to become addicted to anabolic steroids or corticosteroids.

Safety

As with any medication, there are risks, and there are benefits, and the risks must be weighed against the potential benefit.

In life-threatening situations, such as a severe allergic reaction or asthma attack, there is no question about what to do. In most cases, you should talk to your healthcare provider and discuss the possible positive and negative effects of taking a medication.

That said, anabolic steroids have no place outside of medicine. Taking these potent medications for performance enhancement is not only an unnecessary risk—it damages the competitive nature of the sport. Athletes who cheat shift the competitive balance of sports, and are taking a dangerous health risk.

A Word From Verywell

Use of the word "steroids" causes confusion as this can refer to many different substances. The use of steroid injections in the setting of athletic performance enhancement versus treatment of inflammatory conditions is very different.

The medications used, the side effects of these substances, and the effects on the body are all very different. Having a steroid injection for an arthritic knee has nothing to do with people who inject steroids to build muscle. Understanding this distinction is important.