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Anabolic Steroids

Anabolic steroids are powerful prescription drugs, which can only be taken under medical supervision. The chemical composition of anabolic steroid is similar to the testosterone, the male sex hormone. However, anabolic steroids that are produced outside the body are synthetic in nature and have their own side effects. These are androgenic drugs that help in muscle building and increasing the strength of the muscles for a short period of time. Most athletes who use these drugs seek to increase lean muscle mass, endurance and stamina to compete in sports.


Pharmacokinetics

Male gonadotrophic hormones are responsible for the occurrence of adolescence and puberty. These hormones have androgenic effects causing positive anabolic pathways such as muscular development and also secondary sexual characters. Anabolic steroids are designed to act on the muscular physiology of the body by enhancing androgenic activity to increase the definition and size of the muscle tissue. In addition, anabolic steroids also enhance the production of excess skin lipids which can cause acne. The bacteria causing infections invade this acne.

Since testosterone is a male gonadotrophic hormone associated with masculinity; excess production of these hormones especially in females can cause masculine characters such decrease in breast size, deepening of voice and also jawbone elongation. In males, it causes gynecomastia also known as breast development.


Physiological and psychological effects

Administration of anabolic steroids affects the metabolism and causes damage to vital organs such as heart, brain, kidneys and liver. The estimates based on studies imply that there are more that 1,000,000 anabolic steroid users in the United States alone. In a recent surveillance conducted by the FDA, an anabolic supplement called 'mass destruction' was proven to cause liver damage as it affected a young man who used the supplement for a few weeks and required a liver transplant. Similar cases have also been reported in Australia, where there is a significant amount of increase in injectable androgenic and ergogenic drugs.

Oncological surveys indicate the emergence of cancers among sportsmen because of the administration of these steroids. This is due to the increased activity of the cells under the anabolic steroid action. The pathway leading to catabolism is blocked to attain more results by increased performance of the muscle. Although short lived, this mechanism of muscle physiology can cause damage. In some cases treatment to such conditions can become impossible.

Anabolic steroids also have major effects on the brain as they trigger neurotransmitters that enable the person to depend upon the respective steroid. This is similar to caffeine or alcoholic addiction. The dependency grows based upon the peer group, social network or the kind of sport the person is involved in. Withdrawal from anabolic steroids requires appropriate therapy along with counseling in case of addictions.

Cortisone

Cortisone is a steroid and it prevents release of inflammation-causing substances. Cortisone injections are usually used to relieve pain and inflammation. Cortisone is effective against allergic conditions like psoriasis, ulcerative colitis, arthritis, lupus and breathing conditions. Cortisone is also administered to alleviate pain and inflammation in patients suffering from frozen shoulder, plantar fasciitis, carpal tunnel syndrome and bursitis. Typically, most patients experience headache, nausea, stomach pain and bloating. Severe side effects of cortisone include rapid weight gain, vision problems, Pancreatitis, reduced potassium and hypertension. Do not change your cortisone or steroid medication without consulting your physician.


Addison's disease

Addison's disease also known as chronic adrenal insufficiency is a hormonal disorder characterized by tissue necrosis and granulomatous appearance. Addison's disease occurs to people irrespective of age and gender. Addison's disease is also known as hypocortisolism as it is associated with insufficient production of cortisol from the adrenal glands.

Cortisol belongs to the class of glucocorticoid hormones. They are released from the cortex of the adrenal glands located on top of the kidneys. Cortisol has a significant function in the body and is associated with main organ system functions in maintaining the homeostasis in the body. Cortisol is essential in protein, carbohydrate and fat metabolism. It also helps in the regulation and release of insulin for blood sugar balance.

The other important functions of cortisol include maintenance of blood pressure, cardiovascular activity and inflammatory response process associated with the immune system. The level of cortisol in the body is used as a determination of stress management. Cortisol has precursors for its release such as the adrenocorticotropic hormone released due to the stimulus associated with the hypothalamus and pituitary gland.


Clinical manifestations

Addison's disease etiology is predominantly based upon the function of the adrenal gland and the release of cortisol regulated by the pituitary gland. Insufficient cortisol production may be due to impairment of adrenal glands which is categorized as the primary phase in Addison's disease occurrence. The secondary factors are associated with release of adrenocorticotropic hormone levels from the pituitary gland to stimulate the adrenal gland. The tertiary factors are associated with insufficient release of corticotrophin releasing hormone from the hypothalamus.


Significant clinical manifestations include anorexia, vomiting, hypoglycemia, weight loss, cutaneous and mucosal pigmentation, hypernatremia, hyperkalemia, hypotension caused due to extra cellular fluid loss. Excess melanin production is observed along with visible changes in the surfaces of lips and buccal mucosa. Addison's disease can also occur because of preexisting factors such as tuberculosis, histoplasmosis, coccidioiodomycosis , autoimmune diseases and conditions associated with bilateral metastases, hemorrhages, amyloidosis and adrenoleukodystrophy.


Diagnosis of Addison's disease

Addison's disease is diagnosed by clinical symptoms which are correlated with biochemical laboratory tests. The levels of sodium, potassium and other important parameters with respect to inflammatory response and hormonal levels can diagnose the presence of Addison's disease. One of the significant diagnostic tools used to detect the presence of Addison's disease is the ACTH (adrenocorticotropic hormone stimulation test). In this test, ACTH is given intravenously to the patient and the levels of cortisol in urine and blood are examined. This test determines adrenal insufficiency factor.


Addison's disease and pregnancy

Steroid hormone balance and support aids labor and fetal development. Insufficiency of steroid hormones can affect the pregnancy especially during a cesarian. Conditions associated with Addison's disease may increase under situations of emergency. This is because of lack of steroid production in the body. Symptoms such as colds, confusion, increased weakness and fatigue can occur; which may become fatal if untreated.


Diet for Addison's disease

Patients with Addison's disease express cravings for salty food or foods that have citrus flavor. Sufficient intake of proteins balanced with vitamins and minerals is advisable. Many patients suffer dehydration; hence increased fluid intake is advised. Diet patterns can be altered in patients having conditions such as diabetes, hypertension and osteoporosis.

Treatment for Addison's disease

Hydrocortisone and fludrocortisone are generally used to replace the cortisol and aldosterone hormones in cases of adrenal insufficiency. Other options used are prednisone, dexamethasone with slow and sustained release characteristics. The advisable dosage for these steroid hormones is thrice a day to meet with the energy demands and activity of the individual.

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Bibliography / Reference

Collection of Pages - Last revised Date: June 17, 2019