Do anabolic steroids cause liver damage?
Yes, depending on the type of anabolic steroid used, the amount, and the length of time taken.(1,2) When the liver is under stress or damaged, increased amounts of certain chemicals (SGOT, SGPT, and others) are found in the bloodstream. "Liver function tests" detect these chemicals as a measure of stress and possible liver damage. Anabolic steroid abusers have up to twice the level of these chemicals in their blood compared to non-users.(1) These values may return to normal if the person stops taking anabolic steroids.(1) SGOT and SGPT are released while the liver is being injured. Once the damaging process is over, no further release occurs. Whether the damaged tissue repairs itself is unclear. Thus the damage done may continue to exist despite normal SGOT and SGPT blood levels. Oral steroids are more difficult for the liver to metabolize than injectable steroids. Liver cells are damaged as the liver attempts to break down the oral agents.(3) There are changes in the structure of the liver with continued use, and the liver's ability to rid the body of wastes (excretory function) is decreased.(4) In one type of toxicity, blood-filled pockets open inside the liver as a result of steroid use. This is known medically as "peliosis hepatitis," and although rare, is not restricted to high doses or long-term use of steroids. (2,5,6) Injectable steroids do not appear to cause direct chemical damage like oral steroids. However, the injection can carry many kinds of bacteria and viruses past the protective skin and into the blood. Infectious hepatitis is a liver disease transmitted by dirty needles and contact with contaminated blood. It can be life- threatening (Note: Any infectious disease including sexually transmitted diseases and AIDS can be passed through the needle). Anabolic steroids may be tumor growth promoters:(5,7) Steroids promote the growth certain liver cells into "nodules" which closely resemble tumors.(5) If steroid use is stopped, often the nodule will go away by itself.(4,5) However, at least three people have died from tumors thought to have been caused by their steroid abuse.(4,8) A chemical process called "aromatisation" changes anabolic steroids into female hormones called "estrogens."(8) The liver deactivates these estrogens, but consumption of alcohol slows the process down so that the estrogens cause breast development in males.(7,9) This condition is known medically as "gynecomastia." Some researchers believe that gynecomastia in a steroid abuser may also suggest liver damage.(8,10)
1. Oconnor JS, Baldini FD, Skinner JS, Einstein M. Blood
chemistry of current and previous anabolic steroid users.
Military Medicine 1990 Feb;155(2):72-5.
2. Smith DA, Perry PJ. The efficacy of ergogenic agents in
athletic competition. part 1: androgenic-anabolic steroids.
Annals Pharmacother 1992 Apr;26:520-8.
3. Wagner JC. Abuse of drugs used to enhance athletic
performance. American Journal Of Hospital Pharmacy 1989
4. Yesalis CE, Wright JE, Bahrke MS. Epidemiological and policy
issues in the measurement of the long term health effects of anabolic-androgenic steroids. Sports Medicine 1989
5. Creagh TM, Rubin A, Evans DJ. Hepatic tumours induced by
anabolic steroids in an athlete. J Clin Pathol 1988;41:441-3.
6. Wilson JD. Androgen abuse by athletes. Endocrine Reviews
7. Johnson MD. Steroids. Adolescent Med 1991 Feb;2(1):79-93.
8. Hickson RC, Ball KL, Falduto MT. Adverse effects of anabolic
steroids. Med Toxicol Adv Drug Experience 1989 Jul-
9. Giannini AJ, Miller N, Kocjan DK. Treating steroid abuse - a
psychiatric perspective. Clinical Pediatrics 1991
10. Johnson MD. Anabolic steroid use in adolescent athletes.
Pediatr Clin North Am 1990 Oct;37(5):1111-23.
by Trent Tschirgi, R. Ph.
(c) 1992 University of Maryland Office of Substance Abuse Studies.
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