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Testosterone, like many other hormones, is produced only at
certain sites in the body. It does very limited, specific
functions and is quickly metabolized. When testosterone was found
to build muscle tissue and to cause the development of male
secondary sex characteristics, medical researchers tried to use
testosterone to treat diseases that caused the loss of muscle
mass.(1-3)
Unfortunately, testosterone in its natural form has a half
life of only about ten minutes in the body.(4) This means
that half of the dose of testosterone is metabolized away in as
little as ten minutes after it is absorbed. Half of what remains
is broken down every ten minutes after that. At the end of an
hour, none of the original dose of testosterone can be detected in
the body. Injecting natural testosterone into muscle can make it
last as long as ten hours, but this is still not nearly long enough
to be useful as a medicine.(1)
Medicinal chemists began to alter natural testosterone in an
attempt to make drugs that would work like testosterone but last
long enough in the body to have an effect. After extensive
testing, they found that changing the testosterone molecule at one
of only a few specific places would give them what they wanted--
anabolic steroid drugs.(5) These variations are known by
chemists as "17-alpha-alkylates", "17-beta-esters", and "1-methyl"
steroids.(5) All anabolic steroids in use today are
variations of one of those three changes to the testosterone
molecule. These chemical classes of anabolics are taken by
different routes and have different side effects on the body. The
17-alpha-alkylates and 1-methyl compounds are taken by mouth, while
17-beta-esters must be injected to be effective.(1,5)
For convenience, they will be classified here as oral or injectable
steroids.
Oral Steroids:
Oral steroids can be detected in the body for several weeks
after a person stops taking them.(6) This is enough time to
make them useful as medicines, but still a short duration of action
compared with the injectable steroids.(7)
Athletes usually experiment with oral anabolics at first.
They are convenient to store and use, but cause severe side effects
to the liver in addition to the side effects caused by all
anabolics.(8-10) These side effects are described
in detail under the question, "Do anabolic steroids cause liver
damage?"
An athlete will usually continue to use oral drugs even when
he or she begins using injectable steroids. Some use orals to make
it easier to escape drug detection tests: Most oral anabolic
steroids do not remain in the body as long as injectables. As an
event approaches, an athlete may use shorter-duration oral
steroids, then stop using four to six weeks before the event so
that the urine will be steroid-free for urine testing.
Many athletes and trainers also believe that it is necessary
to use oral and injectable steroids at the same time, in certain
patterns. This topic is covered in detail under the question, "How
are anabolics used by athletes?"
Injectable Steroids:
Injectable anabolics are injected into muscle tissue, not into
the veins. They are slowly released from the muscles into the rest
of the body, and may be detectable for months after last
use.(11) Chemically, the injectable steroids are better
tolerated by the body than the oral steroids. Long-term steroid
abusers begin to use them for this reason. However, injection of
any substance creates its own risks and health problems.
Injecting a drug bypasses the body's natural defense
mechanisms against poisoning and infection. If a person
accidentally swallows too much of a drug, he or she may vomit
before enough has been absorbed to cause death. If a person
inhales poisonous smoke or fumes, the coughing reflex may prevent
poisoning. But if a person injects too much of a drug, there is no
easy way to get it back out of the body.
When injections are given in a doctor's office or at the
hospital, great care is taken to sterilize the skin before the drug
is given. Diabetics are taught how to take these same precautions
so that when they inject insulin, they do not cause infection.
Without such precautions, the needle has the ability to carry dirt
and bacteria past the protection of the skin. Hepatitis,
abscesses, and other infections often result from lack of good
sterile technique.(8,12) There have been two cases of
AIDS reported in body builders who shared needles with other body
builders.(8,13)
Injectable anabolics are considered gateway drugs to
injectable drug abuse: A person who becomes accustomed to
injecting anabolics will be more likely to experiment with
injecting other drugs than a person who has never injected
anything. This gateway principle applies to other drugs as well.
For example, people who smoke tobacco are more likely to try
smoking marijuana or crack than those who do not smoke at all.
In our society, people do not enjoy injecting themselves with
syringes. Even diabetics learn to do it only with difficulty. A
steroid abuser who becomes accustomed to injecting him- or herself
with anabolics has a higher risk of injecting cocaine or heroin
than an illicit drug user who does not inject.
REFERENCES 1. Scott MJ, Scott MJ. HIV infection associated with injections of anabolic steroids. J Am Med Assoc 1989 Jul;262(2):207- 8. by Trent Tschirgi, R. Ph. (c) 1992 University of Maryland Office of Substance Abuse Studies
certain sites in the body. It does very limited, specific
functions and is quickly metabolized. When testosterone was found
to build muscle tissue and to cause the development of male
secondary sex characteristics, medical researchers tried to use
testosterone to treat diseases that caused the loss of muscle
mass.(1-3)
Unfortunately, testosterone in its natural form has a half
life of only about ten minutes in the body.(4) This means
that half of the dose of testosterone is metabolized away in as
little as ten minutes after it is absorbed. Half of what remains
is broken down every ten minutes after that. At the end of an
hour, none of the original dose of testosterone can be detected in
the body. Injecting natural testosterone into muscle can make it
last as long as ten hours, but this is still not nearly long enough
to be useful as a medicine.(1)
Medicinal chemists began to alter natural testosterone in an
attempt to make drugs that would work like testosterone but last
long enough in the body to have an effect. After extensive
testing, they found that changing the testosterone molecule at one
of only a few specific places would give them what they wanted--
anabolic steroid drugs.(5) These variations are known by
chemists as "17-alpha-alkylates", "17-beta-esters", and "1-methyl"
steroids.(5) All anabolic steroids in use today are
variations of one of those three changes to the testosterone
molecule. These chemical classes of anabolics are taken by
different routes and have different side effects on the body. The
17-alpha-alkylates and 1-methyl compounds are taken by mouth, while
17-beta-esters must be injected to be effective.(1,5)
For convenience, they will be classified here as oral or injectable
steroids.
Oral Steroids:
Oral steroids can be detected in the body for several weeks
after a person stops taking them.(6) This is enough time to
make them useful as medicines, but still a short duration of action
compared with the injectable steroids.(7)
Athletes usually experiment with oral anabolics at first.
They are convenient to store and use, but cause severe side effects
to the liver in addition to the side effects caused by all
anabolics.(8-10) These side effects are described
in detail under the question, "Do anabolic steroids cause liver
damage?"
An athlete will usually continue to use oral drugs even when
he or she begins using injectable steroids. Some use orals to make
it easier to escape drug detection tests: Most oral anabolic
steroids do not remain in the body as long as injectables. As an
event approaches, an athlete may use shorter-duration oral
steroids, then stop using four to six weeks before the event so
that the urine will be steroid-free for urine testing.
Many athletes and trainers also believe that it is necessary
to use oral and injectable steroids at the same time, in certain
patterns. This topic is covered in detail under the question, "How
are anabolics used by athletes?"
Injectable Steroids:
Injectable anabolics are injected into muscle tissue, not into
the veins. They are slowly released from the muscles into the rest
of the body, and may be detectable for months after last
use.(11) Chemically, the injectable steroids are better
tolerated by the body than the oral steroids. Long-term steroid
abusers begin to use them for this reason. However, injection of
any substance creates its own risks and health problems.
Injecting a drug bypasses the body's natural defense
mechanisms against poisoning and infection. If a person
accidentally swallows too much of a drug, he or she may vomit
before enough has been absorbed to cause death. If a person
inhales poisonous smoke or fumes, the coughing reflex may prevent
poisoning. But if a person injects too much of a drug, there is no
easy way to get it back out of the body.
When injections are given in a doctor's office or at the
hospital, great care is taken to sterilize the skin before the drug
is given. Diabetics are taught how to take these same precautions
so that when they inject insulin, they do not cause infection.
Without such precautions, the needle has the ability to carry dirt
and bacteria past the protection of the skin. Hepatitis,
abscesses, and other infections often result from lack of good
sterile technique.(8,12) There have been two cases of
AIDS reported in body builders who shared needles with other body
builders.(8,13)
Injectable anabolics are considered gateway drugs to
injectable drug abuse: A person who becomes accustomed to
injecting anabolics will be more likely to experiment with
injecting other drugs than a person who has never injected
anything. This gateway principle applies to other drugs as well.
For example, people who smoke tobacco are more likely to try
smoking marijuana or crack than those who do not smoke at all.
In our society, people do not enjoy injecting themselves with
syringes. Even diabetics learn to do it only with difficulty. A
steroid abuser who becomes accustomed to injecting him- or herself
with anabolics has a higher risk of injecting cocaine or heroin
than an illicit drug user who does not inject.
REFERENCES 1. Scott MJ, Scott MJ. HIV infection associated with injections of anabolic steroids. J Am Med Assoc 1989 Jul;262(2):207- 8. by Trent Tschirgi, R. Ph. (c) 1992 University of Maryland Office of Substance Abuse Studies