Performance enhancing drugs like steroids can have both beneficial and adverse effects. Glucocorticoids are produced by the adrenal glands and have anti-inflammatory and stress response functions but long term use can cause rebound deterioration and complications. Androgens and anabolic steroids are synthetic forms of testosterone that are used by bodybuilders to increase muscle and bone growth but can cause long term side effects like acne, increased aggression, liver damage, and cardiovascular and reproductive issues.

1. Performance Enhancing Drugs

2. The Word “Steroid” a Primer Adrenal glands just above the kidneys synthesize: Glucocorticoids (cortisol) Antiinflammatory (treat allergic reactions, skin, respiratory, opthalmic, RA, CA) Maintain BP Carbohydrate, Protein, Fat metabolism Stress and CNS mood effects Cortisone, Prednisone, Hydrocortisone, Prednisolone

3. Role of Glucocorticosteroid Inhibit inflammation Cause leukocytes to be sluggish Complications with long term use Rebound deterioration Importance of Taper Sample Agents Prednisone, prednisolone, dexamethasone

4. Glucocorticoids Adverse Effects

5. Glucocorticoids Adverse Effects CV Na retention GI PUD Metabolic Redistribution of fat, hyperglycemia Immune infections Dematologic Impair wound healing Musculoskeletal Osteoporosis Bone fractures Neuropsychiatric Psychosis/mood Opthalmic Cataracts/glaucoma

6. Mineralcorticoids (primarily aldosterone) Production of aldosterone stimulated by salt depletion and causes sodium retention in the kidney Increases urinary excretion of potassium Job is to regulate the balance of Na ++ and K+ in the blood. Androgens (primarily dehydroepiandrosterone) Enhance male characteristics and control growth of hair follicles in the skin Anabolic-Androgenic steroids are synthetic formulations produced from testosterone, the male hormone. Estimated use by 80% of weightlifters & bodybuilders

7. Tissues Targeted by Testosterone and Anabolic Steroids

8. Major Effects of Anabolic Steroids Androgen Type Effects Increased growth of : prostate gland Body/facial hair Oil production Deepening voice Increased sexual interest and desire Enhancement of abstract thinking Increased aggression Anabolic Type Effects Increased: Organ and skeletal muscle mass Calcium in bones Retention of nitrogen Hemoglobin concentration Protein synthesis

9. Long Term Adverse Effects Females Oily skin acne Decrease breast size, ovulation, lactation, menstruation Hoarse/deep voice Clitoral enlargement Unusual hair growth +/- male patterned baldness Males Increase penis size, # of erections, & secondary male characteristics Priapism (continuing erections) Gynecomastia (increased breast size) Testicular atrophy, impotence

10. BOTH Genders Gastric ulcers Liver Complications Hyperglycemia Reduction in HDL Increased platelet aggregation with increased risk of CV disorders Hypercalcemia Edema Urinary calculi Insomnia Iron deficiency anemia Nausea, vomiting, anorexia, stomach pains