The Heartless Effects of Anabolic Steroid Abuse by Jerry Brainum 1/26

 

 

A new study that examined the effects of high-dose anabolic steroids on heart function produced alarming news for bodybuilders and athletes who use the drugs. Nearly all the recent deaths attributed to anabolic steroid use in bodybuilders have involved cardiovascular causes. High-dose steroid usage produces the most severe side effects in the liver and the heart, but it's the effects on the heart that can cause early mortality in an otherwise healthy young athlete. Not even testosterone is exempt from producing adverse effects on the cardiovascular system, although the possible severe side effects of testosterone replacement therapy (TRT) are a matter of contention. Some studies suggest that any supplemental testosterone, even with the relatively conservative doses that typify TRT, can nonetheless promote adverse effects related to increased risk of atherosclerosis, an accumulation of plaque in blood vessels that is a forerunner of possible heart attacks. 

 Using anabolic steroid drugs, which are synthetic analogs of testosterone developed to emphasize anabolic rather than androgenic effects associated with testosterone, always causes abnormalities related to cardiovascular function. The higher the dose and more drugs used, the more significant the impact on cardiovascular function. The most common changes seen with anabolic steroid use are adverse changes in blood lipids. Specifically, using anabolic steroids, especially oral versions, hastens the breakdown in the liver of a protective form of cholesterol called high-density lipoprotein or HDL while increasing low-density lipoprotein or LDL. The problem is that elevated LDL is linked to cardiovascular disease (CVD) development. However, more recent research shows that a more direct indication of future cardiovascular disease is the protein associated with LDL, called Apoliprotein-B. If you want to know your actual risk of acquiring CVD, you should be tested for Apo-B and another substance called Lipoprotein (a), both of which are never tested in the usual blood testing lipid panel.

The good news about steroids and CVD is that nearly all the adverse effects caused by using steroids reverse when the drug use stops. This means that the elevated LDL and low HDL return to normal, as does elevated blood pressure, which can be caused by heavy use of drugs. This reversal, however, doesn't apply to those who use the more recent "Cruise and Blast" style of using steroids that is marked by alternate periods of high and low-dose steroid use. This method is ostensibly used to avoid the withdrawal effects that occur after steroid use ceases, including muscle loss. A more rational way to handle that problem is Post-Cycle Therapy or PCT, which is discussed elsewhere in this issue of Applied Metabolics. I said that "nearly" all CVD side effects recede when steroid use ends because, in recent years, research has shown that persistent adverse effects still exist in the heart even when steroid use ends. These persistent effects involve structural . . .