Anabolic Steroids

What are anabolic steroids?

Anabolic steroids are synthetic (man-made) versions of testosterone. Testosterone is the main sex hormone in men. It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Women do have some testosterone in their bodies, but in much smaller amounts.

Health care providers use anabolic steroids to treat some hormone problems in men, delayed puberty, and muscle loss from some diseases. But some people misuse anabolic steroids by taking them in a way that's different than their provider prescribed.

Some bodybuilders and athletes use anabolic steroids to build muscles and improve athletic performance. They may take steroids by swallowing tablets or capsules, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses used to treat medical conditions. Using them this way, without a prescription from a provider, is not legal or safe.

Misuse of anabolic steroids, especially over a long period of time, has been linked with many health problems, including:

• Acne
• Stunted growth in teens
• High blood pressure
• Changes in cholesterol
• Heart problems, including heart attack
• Liver disease, including cancer
• Kidney damage
• Mood changes such as irritability and aggressive behavior

In men, it can also cause:

• Baldness
• Breast growth
• Low sperm count/infertility
• Shrinking of the testicles
• Testicular cancer

In women, it can also cause:

• Changes in your menstrual cycle (period)
• Growth of body and facial hair
• Male-pattern baldness
• Voice deepening
• Decreased breast size

Even though they don't cause a high, anabolic steroids can lead to addiction. You can have withdrawal symptoms if you stop using them, including:

• Fatigue
• Restlessness
• Loss of appetite
• Sleep problems
• Decreased sex drive
• Steroid cravings
• Depression, which can sometimes be serious and even lead to suicide attempts

Behavioral therapy and medicines can be helpful in treating anabolic steroid addiction

NIH: National Institute on Drug Abuse

Blood Clots

What is a blood clot?

A blood clot is a mass of blood that forms when platelets, proteins, and cells in the blood stick together. When you get hurt, your body forms a blood clot to stop the bleeding. After the bleeding stops and healing takes place, your body usually breaks down and removes the blood clot. But sometimes the blood clots form where they shouldn't, your body makes too many blood clots or abnormal blood clots, or the blood clots don't break down like they should. These blood clots can be dangerous and may cause other health problems.

Blood clots can form in, or travel to, the blood vessels in the limbs, lungs, brain, heart, and kidneys. The types of problems blood clots can cause will depend on where they are:

• Deep vein thrombosis (DVT) is a blood clot in a deep vein, usually in the lower leg, thigh, or pelvis. It can block a vein and cause damage to your leg.
• A pulmonary embolism (PE) can happen when a DVT breaks off and travels through the bloodstream to the lungs. A PE, especially if it is large, can damage your lungs and prevent your other organs from getting enough oxygen.
• Cerebral venous sinus thrombosis (CVST) is a rare blood clot in the venous sinuses in your brain. Normally the venous sinuses drain blood from your brain. CVST blocks the blood from draining and can cause a hemorrhagic stroke.
• Blood clots in other parts of the body can cause problems such as an ischemic stroke, a heart attack, kidney problems, kidney failure, and pregnancy-related problems.

Certain factors can raise your risk of developing blood clots:

• Atherosclerosis
• Atrial fibrillation
• Being overweight or having obesity
• Cancer and cancer treatments
• Certain genetic disorders
• Certain surgeries
• COVID-19
• Diabetes
• Family history of blood clots
• Overweight and obesity
• Pregnancy and giving birth
• Serious injuries
• Some medicines, including birth control pills
• Smoking
• Staying in one position for a long time, such as being in the hospital or taking a long car or plane ride

The symptoms for blood clots can be different, depending on where the blood clot is:

• In the abdomen: Abdominal pain, nausea and vomiting
• In an arm or leg: Sudden or gradual pain, swelling, tenderness, and warmth
• In the lungs: Shortness of breath, pain with deep breathing, rapid breathing, and increased heart rate
• In the brain: Trouble speaking, vision problems, seizures, weakness on one side of the body, and sudden severe headache
• In the heart: Chest pain, sweating, shortness of breath, and pain in the left arm

To find out if you have one or more blood clots, your health care provider:

• Will do a physical exam.
• Will take your medical history, which includes asking about your symptoms.
• May order blood tests, including a D-dimer test.
• May order imaging tests, such as
  • Ultrasound.
  • X-rays of the veins (venography) or blood vessels (angiography) that are taken after you get an injection of special dye. The dye shows up on the x-ray and allows the provider to see how the blood flows.
  • CT Scan.

Treatments for blood clots depend on where the blood clot is located and how severe it is. Treatments may include:

• Blood thinners.
• Other medicines, including thrombolytics. Thrombolytics are medicines that dissolve blood clots. They are usually used where the blood clots are severe.
• Surgery and other procedures to remove the blood clots

You may be able to help prevent blood clots by:

• Moving around as soon as possible after having been confined to your bed, such as after surgery, illness, or injury
• Getting up and moving around every few hours when you have to sit for long periods of time, for example if you are on a long flight or car trip
• Wearing compression stockings after surgery or during a long flight
• Regular physical activity
• Not smoking
• Staying at a healthy weight

Some people at high risk may need to take blood thinners to prevent blood clots.

Blood Count Tests

Your blood contains red blood cells (RBC), white blood cells (WBC), and platelets. Blood count tests measure the number and types of cells in your blood. This helps doctors check on your overall health. The tests can also help to diagnose diseases and conditions such as anemia, infections, clotting problems, blood cancers, and immune system disorders.

Specific types include tests for:

• RBC - the numbers, size, and types of RBC in the blood
• WBC - the numbers and types of WBC in the blood
• Platelets - the numbers and size of the platelets
• Hemoglobin - an iron-rich protein in red blood cells that carries oxygen
• Hematocrit - how much space red blood cells take up in your blood
• Reticulocyte count - how many young red blood cells are in your blood
• Mean corpuscular volume (MCV) - the average size of your red blood cells

The complete blood count (CBC) includes most or all of these. The CBC is one of the most common blood tests.

NIH: National Heart, Lung, and Blood Institute

Blood Disorders

Your blood is living tissue made up of liquid and solids. The liquid part, called plasma, is made of water, salts and protein. Over half of your blood is plasma. The solid part of your blood contains red blood cells, white blood cells and platelets.

Blood disorders affect one or more parts of the blood and prevent your blood from doing its job. They can be acute or chronic. Many blood disorders are inherited. Other causes include other diseases, side effects of medicines, and a lack of certain nutrients in your diet.

Types of blood disorders include:

• Platelet disorders, excessive clotting, and bleeding problems, which affect how your blood clots
• Anemia, which happens when your blood does not carry enough oxygen to the rest of your body
• Cancers of the blood, such as leukemia and myeloma
• Eosinophilic disorders, which are problems with one type of white blood cell.

Bone Density

What is bone density?

Your bones are made of living tissue. To keep them strong, your body breaks down old bone and replaces it with new bone. But when more bone is broken down than replaced, you lose bone density, also called bone mass. Bone density is a measure of the amount of calcium and other minerals in bone. Bones containing more minerals are denser. They tend to be stronger and less likely to fracture (break).

Losing bone density can weaken your bones. In some cases, it can lead to osteoporosis. This is a disease which can make your bones more likely to break. Low bone density that is not low enough to be osteoporosis is sometimes called osteopenia.

Your bones become less dense as you age. Other factors can also make you more likely to lose bone mass, such as:

• A family history of osteoporosis or low bone mass
• Not developing good bone mass when you are young
• Having certain medical conditions, such as:
  • Endocrine diseases
  • Certain digestive diseases
  • Rheumatoid arthritis
  • Certain types of cancer
  • HIV
  • Anorexia nervosa, a type of eating disorder
• Taking certain medicines, such as:
  • Corticosteroids
  • Proton pump inhibitors (which treat GERD)
  • Medicines to treat epilepsy
• Smoking tobacco
• Long-term heavy alcohol use
• Physical inactivity or prolonged periods of bedrest

Not everyone who has low bone mass gets osteoporosis, but they are at higher risk for developing it.

A bone density scan is the best way to measure your bone health. It compares your bone density, or mass, to that of a healthy person who is the same age and sex as you are. It can show:

• Whether you have low bone density
• Whether you have osteoporosis, a disease that makes your bones weak
• Your risk for breaking bones
• Whether your osteoporosis treatment is working

To help keep your bones strong and help prevent osteoporosis, the best thing to do is to eat a healthy diet rich in calcium and vitamin D. Getting regular physical activity, limiting alcohol, and not smoking can also help. In some cases, your health care provider may prescribe medicines to prevent osteoporosis.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases