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What is the Difference Between Prescribed Steroids and Those Taken By Athletes?

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Updated June 10, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: What is the Difference Between Prescribed Steroids and Those Taken By Athletes?
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 doctor?
Answer: A steroid is a chemical compound that has several specific characteristics. Essentially, all steroids share some basic components of their molecular structure, but steroids are a broad class of molecules, and different steroids have very different properties. Most people think of steroids in the context of athletic performance, or a prescribed medication, but there are many steroids beyond these parameters.

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 characteristic steroid molecules.

Common Steroids

  • 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 the 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 low testosterone for aging.

  • Corticosteroids

  • Corticosteroids are medications that have effects on inflammation in the body — a process known as a 'cascade of events.' This cascade means that, for inflammation to develop, a series of events takes 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 blood stream, 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, allergic reactions, and many other problems.

    Steroid Side Effects

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

    Anabolic steroids are notorious for causing mood swings, aggressive actions, and risky/impulsive behavior. 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, and tendon rupture.

    Neither anabolic steroids nor corticosteroids have addictive properties, but the effects can cause addictive behavior.

    Is It OK to Take a Steroid?

    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 doctor 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.

    Sources

    Silver MD "Use of Ergogenic Aids by Athletes" J Am Acad Orthop Surg January/February 2001; 9:61-70.

    Fadale PD and Wiggins ME "Corticosteroid Injections: Their Use and Abuse" J. Am. Acad. Ortho. Surg., May 1994; 2: 133 - 140.

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