What do I need to know before using AAS?
Information taken from FDA sources. Shows their view of the situation on the market today. Anabolic steroids (also known as androgenic steroids) are synthetic derivatives of testosterone. Legal as well as illegal use of anabolic steroids has always had its popularity and has been in demand. There are two types of anabolic steroids: 1) 17-alpha-alkyl derivatives and 2) 17-beta ester derivatives. All anabolic steroids are DEA III listed drugs. This article wants to cover the mechanism of action, adverse event profile, and other key factors in the use of AAS (e.g., use outside the registered indications, dosage, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions).
When the drugs first hit the market, experts set themselves goals and objectives for the use of AAS, the main objectives were:
Objectives:
- Identify medically approved indications for anabolic steroid therapy.
- Describe the general mechanism of action of drugs of the anabolic steroid class.
- Summarize possible side effects and indicate appropriate monitoring of side effects when using anabolic steroids.
- Describe interprofessional team strategies to improve care coordination and communication to improve appropriate clinical outcomes of anabolic steroid therapy and improve outcomes, as well as measures to prevent misuse.
What are the indications?
There are two types of anabolic steroids: 1) 17-alpha-alkyl derivatives: such as oxandrolone, oxymetholone, and fluoxymesterone; and 2) 17 beta ester derivatives: such as testosterone cypionate, testosterone enanthate, testosterone heptylate, testosterone propionate, nandrolone decanoate, nandrolone phenropionate .There is information that Nandrolone phenylpropionate is an androgenic anabolic steroid and was one of the first anabolic steroids used as doping by professional athletes in the 1960s. It was banned from the Olympic Games by the IOC in 1974.
Indications for FDA-approved anabolic steroids include primary hypogonadism, delayed puberty in boys (testosterone enanthate), hypogonadotropic hypogonadism (testosterone cypionate, enanthate, and undecanoate), gonadotropin and luteinizing hormone-releasing-hormone deficiency, pituitary hypothalamic axis dysfunction from various tumors, injuries, and radiation exposure. Other indications for testosterone include primary testicular insufficiency in patients with cryptorchidism, orchitis, testicular torsion, disappearing testis syndrome, history of orchiectomy, Klinefelter syndrome, chemotherapy agents, toxic lesions from alcohol and heavy metal use.
Non-FDA approved indications for the use of androgenic steroids include bone marrow stimulation for leukemia, aplastic anemia, renal failure, growth retardation, appetite stimulation, and muscle mass in malignant tumors and acquired immunodeficiency syndrome. Anabolic steroid users are sometimes used by athletes of all levels in sports such as bodybuilding, weightlifting, baseball, soccer, cycling, wrestling, and many others to improve their performance.
Mechanism of influence
Endogenous androgen is responsible for the growth and development of the male reproductive organs and the maintenance of secondary sexual characteristics. Endogenous anabolic steroids, such as testosterone and dihydrotestosterone, as well as synthetic anabolic steroids mediate their effects by binding to androgen receptors and activating them. In skeletal muscle, anabolic steroids regulate the transcription of target genes, which control the accumulation of DNA in skeletal muscle necessary for muscle growth.
Anabolic steroids also activate and increase the number of androgen receptors, which allows you to increase the intensity of exercise and indirectly contributes to an increase in muscle size and strength. They also have a stimulating effect on the brain through a variety of effects on different neurotransmitters of the central nervous system, antagonism of glucocorticoids and stimulation of the growth hormone-insulin-like growth factor-1 axis.
Since we have touched such preparations as Nandrolone Decanoate and Nandrolone Phenylpropionate (a little about their properties) are associated with an increased ratio of anabolic activity to androgenic activity. Nandrolone decanoate is a slow-acting anabolic steroid designed to increase muscle mass. It works by promoting nitrogen retention in the muscles, resulting in increased muscle size and joint pain relief, stimulating collagen synthesis and increasing bone mineralization. Nandrolone phenpropionate also causes increased muscle growth, appetite stimulation, and increased red blood cell production.
Administration
The administration of anabolic steroids can be in the form of oral tablets, injections, creams or gels for topical application, and skin patches.
- Testosterone cypionate is prescribed 50-400 mg intramuscularly 1 to 4 times a month for primary hypogonadism and hypogonadotropic hypogonadism.
- The dosing of testosterone undecanoate begins with an initial dose of 750 mg, followed by 750 mg administered four weeks after the first dose, and then 750 mg at ten-week intervals between each dose.
- Testosterone gel is prescribed at 11 mg three times a day, for a total dose of 33 mg per day.
- Transdermal testosterone is used as 50 mg once daily in the morning on the upper extremity, shoulder, or abdomen with a maximum dose of 100 mg per day.
- Another testosterone gel is given at a dose of 40 mg once a day every morning with a maximum dose of 70 milligrams per day.
This protocol is taken and approved by the FDA
Drugs not approved by the FDA for medical use
The dosage of nandrolone decanoate is 100 mg per week for comfort and joint pain relief and in the 200 to 400 mg per week dosage range for increased growth and performance. It is ideal to use for about ten to twelve weeks to get the desired results in athletes, powerlifters, and bodybuilders.
Side effects
Below is a list of some of the side effects of anabolic steroids:
- Cardiovascular: coronary heart disease, cardiomyopathy, and hypertension (3% or less)
- Endocrine and metabolic: decreased HDL cholesterol (6% or less), hyperlipidemia (6% or less), hypokalemia, increased serum triglyceride levels, thyroid hormone and plasma estradiol concentrations, decreased libido (3% or less), gynecomastia (3% or less), hot flashes and weight gain
- Gastrointestinal tract: gingivitis (9% or less), mouth irritation (9% or less), increased serum bilirubin levels, impaired liver function, decreased appetite, dysgeusia, gastroesophageal reflux disease and gastrointestinal bleeding.
- Genitourinary system: increased prostate-specific antigen levels (locally 18% or less), benign prostatic hypertrophy (12%), testicular atrophy (6% or less), suppression of spermatogenesis, mastalgia, hypogonadism (after withdrawal), prostatitis, dysuria, hematuria. , impotence, pelvic pain, urinary incontinence, urinary tract infection, testicular pain, ejaculation disorders, and erectile dysfunction (nandrolone)
- Hematological and oncological: polycythemia (6%) and prostate carcinoma (less than 3%) .
- Neuromuscular system and skeleton: myalgia (6% or less), premature closure of epiphyses (if taken before puberty), limb pain, tendon rupture, abnormal bone growth and hemarthrosis.
- Neuropsychiatric: emotional lability, severe mood disorders, anosmia, headaches, depression, nervousness, body pain, violence, insomnia, and aggressive behavior .
- Dermatological: skin blisters (12%), vulgar acne (8% or less), skin crusts, nasal irritation (6% or less), contact dermatitis, bullae, skin rashes, and itching.
- Kidneys: increase in serum creatinine and urinary frequency.
- Nandrolone causes hirsutism and coarsening of the voice in women with long-term use because of its androgenic properties.
Contraindications
Testosterone cypionate is contraindicated in the presence of severe kidney, heart and liver disease, men with breast cancer and prostate cancer, venous thromboembolism, pregnant women or women who may become pregnant, breastfeeding women, hypersensitivity to any component of the drug. The Society of Endocrinologists suggests that it would be prudent to avoid testosterone treatment in men who have a history of myocardial infarction and stroke within the past six months.
Monitoring
Before starting testosterone treatment, the diagnosis of hypogonadism must be confirmed by measuring testosterone levels early in the morning on two different days. Lipid profile, liver function tests, hemoglobin, hematocrit, prostate-specific antigen, and prostate exams in patients over 40 years of age are required before starting treatment.
During treatment with anabolic steroids, clinicians should obtain the patient's lipid profile, liver function tests, hemoglobin, and hematocrit (after 3-6 months, then every year). Women receiving testosterone for breast cancer require monitoring for signs of virilization. Patients taking testosterone should be monitored for their response to treatment and side effects three to six months after starting therapy, and then annually thereafter, especially for adverse cardiac events.
Men over 40 years of age with baseline prostate-specific antigen (PSA) levels greater than 0.6 ng/mL should have PSA levels measured and prostate exams performed for 3 to 6 months. Treatment should be suspended in men with a palpable prostatic nodule or prostate-specific antigen levels greater than 4 ng/mL, as well as in patients at high risk of prostate malignancy with prostate-specific antigen levels greater than 3 ng/mL.
Testosterone levels should be measured midway between injections of testosterone enanthate and testosterone cypionate, and the dose and frequency of administration should be adjusted to maintain testosterone concentrations between 400 ng/dL and 700 ng/dL (this is the Endocrinology Society 2010 standard). Serum testosterone levels should be measured two to eight hours after administration and fourteen days after initiation of therapy or during dose titration in patients using testosterone solution for topical administration.
Serum total testosterone should be measured periodically beginning in the first month after initiation of therapy in patients using nasal testosterone gel, and treatment should be discontinued if total testosterone exceeds 1050 ng/dL. Serum testosterone levels should be measured approximately 14 days after initiation of therapy, in the morning, before using transdermal (I hope many understand this is through the skin) testosterone, at the end of the dosing interval in testosterone tablets and 4-12 weeks after treatment and before the morning dose in patients using transbuccal( Transbuccal drug administration is the pharmacological term for taking a certain drug by placing it between the mucosa of the inner cheek and gums with teeth until it has completely dissolved
Results
When used correctly, anabolic steroids can help, both in difficult situations and not so much. In general, when used for a short period of time and when indicated, anabolic steroids can get rid of or prevent side effects. At the same time, you need to find the optimal dosage that does not carry side effects. So sometimes professional sports can go very far...