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A Complete Guide to Steroid Side Effects and their Treatments

I have compiled a list of all the possible steroid side effects and their corresponding treatments. It is important to note that these are possible side effects and most of them are extremely rare despite what the media and health industry may have suggested. Having an AI on hand during your cycle and a good PCT program post cycle will eliminate the possibility of experiencing most of the side effects. Hopefully the following list will prove to be a good reference point if you run into trouble:

Quick Guide

Acne (oily Skin)

acne

Acne is a common side effect of steroids because the sebaceous glands, which secrete oil into the skin are stimulated by androgens. Treatment of acne should begin with a decent cleaning routine, keeping your skin clean and removing excess oil as regularly as possible will minimise a lot of the effects. For more serious cases try some over-the-counter acne medication or speak to a dermatologist. Arimidex or some sort of AI (Aromatise Inhibitor) whilst on cycle is recommended as well as it will help control hormonal changes that are associated with acne. In most cases the acne will gradually improve once off cycle anyway.

Steroid use is commonly associated with increased aggression but the link is not as clear-cut as it would seem. A number of studies have inconsistent results and it would seem the individual involved is the more important factor for any aggression changes. Irritability from other side effects would appear the largest contributor to increased aggression so anything you can do to limit these would be beneficial. New research suggests an AI to control hormonal changes may also help reduce aggressive behaviour but largely the side effect is exaggerated.

Aggressiveness

aggresiveness

Baldness

baldness

Male Pattern Baldness (MPB) is much more common for users with a genetic pre-disposition, so if you have family members who have MPB then it may be a concern for you. If you begin to find hair on your pillow or seem to lose more than usual in the shower then Finasteride can be very effective in treating your hair loss. Another drug that is effective is Dutasteride but both come with their own side effects. An anecdotal treatment that does well is Nizoral shampoo (2%), which is commonly mentioned favourably and should help strengthen the scalp and the hair roots.

Diabetes is actually attributed with Growth Hormones (GH) as opposed to steroids. GH triggers the release of fatty acids into the blood, which interfere with the uptake of glucose into cells. This causes the body to compensate by releasing more insulin, which the cells eventually become resistant to known as insulin resistance. Insulin resistance is a known forerunner of diabetes. To counter this many GH users will inject insulin directly avoiding hyperglycemia and limit their exposure to the drugs. I mention it here because it is often miss-associated with anabolic steroids and I often have people ask me.

Diabetes

diabetes

Increased Body Hair

bodyhair

Whilst steroid use can cause baldness in some men (see above) it can also cause increases in body hair as well. Researches believe this paradox is gene related. What researchers have found is that individual hair follicles have different expression of genes within the follicle. Each gene expression reacts differently to androgen. Some genes inhibit follicle health and some increase follicle health. Since each follicle is independent of one another, each gene expression is also independent of one another.

Testosterone comes into play because it regulates hair growth by affecting the follicle directly. There are two types of follicles on our body; Vellus (fine colourless hair) and Terminal (thicker, longer hair). Terminal follicles are created from Vellus follicles with increased androgen such as going through puberty. It follows that increased testosterone from AAS may have a similar effect if your genetically predisposed.

Unfortunately other than a razor and wax there is no way around this side effect if you are going to get it. Stronger steroids like Tren may have a greater effect but any androgen will have some affect. Having said that for the vast majority of users it is barely noticeable.

Steroid use for those under 21 or those who have not reached full height is strongly recommended and one of the main reasons for that is the potential to limit growth. It is probable that the premature closure of the epiphysial cartilage, which is most likely caused by aromatizable steroids, will lead to a possible growth inhibiting effect, and could ultimately result in a shorter adult height. This is most likely an irreversible side effect, as the growth plates would have fused and can not “re-open”. In 99.9% of humans, the process of bone elongation ends at around the mid to late teen years. At this point, the growth plates are obliterated and disappear, after which no more elongation (typified by an increase in limb length, i.e. height) can take place. If you are not achieving natural gains under 21 then steroids will do more harm then good, your diet and training should be closely looked at first.

Growth inhibitor

growth-inhibitor

Gynocomastia (Gyno)

gyno

Gyno is caused from an increase level of Estrogen in the body. This may interact with the estrogen receptors on the breast tissue causing growth and can be picked up during early onset if you have itchiness, puffiness or increased sensitivity around the nipples.

Gyno is easy to treat, manage and prevent. A good AI on cycle such as Arimidex will prevent excess Estrogen in the system and therefore prevent the onset of Gyno.

Steroids are known to lower the protective high density lipoprotein cholesterol (HDL), cause a possible rise in blood pressure, increase the thickness of your blood and have adverse effects on blood clotting factors. Again people with pre-existing conditions are more susceptible to any heart issues, whilst for the majority of healthy users side effects won’t be an issue at all. A clean diet and some cardio to your routine will keep your heart strong and blood pressure should return to normal on your off cycle.

Heart problems including High blood pressure

heart-problems

Heartburn

heartburn

Heartburn is a side effect of taking oral steroids. As the steroid releases in the stomach it can react with your stomach acid causing great discomfort for some users. If it’s near unbearable you should see a doctor to rule out acid reflux. For the rest of us a good idea is to take the tablet inside a spoon full of peanut butter to slow down the release. Over the counter medicines can also help a lot such as Zantac or Pepcid and a number of users like to use a 5 day on, 2 day off cycle on orals to help reduce heartburn and also to help keep their livers healthy.

Elevated cholesterol is another side effect of steroids. This mainly affects users who had high cholesterol levels to begin with and in healthy users cholesterol levels will subside back to normal levels at the completion of the cycle. It is caused primarily from the hormonal imbalance produced from taking steroids. In particular the reduction of estrogen in relation to testosterone, progesterone and DHT, reduces the amount of HDL (good cholesterol being produced. Also hormones in the body are produced from cholesterol so by stopping or slowing this production you will naturally get a cholesterol increase.If cholesterol is of concern during cycle there are number of things you can do to help. Firstly stay away from the orals and AI’s as they have the most impact on cholesterol levels. Secondly keep your diet clean and add some cardio to your workout. You should be taking some omega-3 supps anyway but if you’re not get some fish oil or krill oil supplements into your diet. Niacin (Vit-B3) has an excellent reputation with controlling cholesterol, but get the no-flush version to avoid some uncomfortable side effects. If cholesterol is still an issue you should see your doctor who could proscribe something stronger such as Lipitor.

High Cholesterol levels

cholestorol

Infertility

infertility

Steroids interfere with the signals in your body that tell it to produce sperm or in medical speak the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). As a result you will have a reduction in your sperm counts. Some users may be unable to conceive whilst on cycle but there is no evidence that steroids alone will cause permanent infertility. However a proper PCT program complete with HCG (Human chorionic gonadotropin) will get you back to your pre-cycle state. Some high risk users or men trying to conceive take HCG whilst on cycle as well to keep the reproductive system in balance.

This is probably the most common of the Steroid side-effects and is often (falsely) claimed to be irreversible. Essentially the body tries to stay in a balanced state known as homeostasis. When hormones are introduced into the body (for example testosterone from anabolic steroids) the brain will tell the testes to stop producing its own hormones in an attempt to create balance. Several studies have conclusively proven that natural hormone production is reduced either mildly to almost completely during steroid use. However in almost all cases the natural hormone production returns to a normal state soon after the completion of a cycle. Longer term studies have found no long-term effects from steroid use once a year has passed since the last injection of steroids in the body. However for faster recovery (more gains) it is recommended to complete a PCT program after every cycle. This will ensure your natural production returns to 100% and as quickly as possible.

Inhibition of Natural Hormones

hormones

Jaundice (yellowing of skin or eyes)

jaundice

Jaundice is generally a sign of liver stress and is most common with oral steroids. Because orals are designed to resist premature degradation in the liver this may cause the liver to work a lot harder. For almost all users this won’t be a problem but in rare cases can cause Jaundice. Jaundice almost always shows up first in the whites of your eyes. The first course of action is to discontinue the offending agent and taking milk thistle immediately should help ameliorate the damage and if you are drinking alcohol or stressing your liver with other drugs it would be worth discontinuing these as well until symptoms pass.

High blood pressure that develops as a result of steroid use can harm the kidneys. The kidneys themselves have higher blood pressure to effectively filter the blood, but when systemic blood pressure rises excessively, the nephrons, which are the filtering units of the kidneys, are slowly destroyed. Also a number of steroid users have developed a condition called focal segmental glomerulosclerosis. FSGS involves the formation of scar tissue in the kidneys. It usually results from excessive stress on the kidneys and is often seen in morbidly obese people. It is marked by excessive loss of protein in the urine, along with severe reduction in kidney function. However the links with steroids are tenuous at best and the side effects so rare as to be put down to pre-existing conditions. If you don’t abuse steroids and cycle off regularly your kidneys will be fine.

Kidney Damage

kidney

Liver Damage

liver

Oral steroids are designed to resist breakdown in the liver, which would result in rapid deactivation. As a result, they can accumulate in the liver to the extent that they cause an inflammation of the liver, a chemical hepatitis. An inflamed liver tends to interfere with bile circulation, which can damage liver cells. If not treated or if the oral drugs continue to be used, excessive liver cell destruction can ensue. In a worst-case scenario that can result in life-threatening problems, such as peliosis, a collection of blood-filled cysts in the liver.

Androgenic and anabolic steroids have been implicated in four distinct forms of liver injury: transient serum enzyme elevations, an acute cholestatic syndrome, chronic vascular injury to the liver (peliosis hepatis) and hepatic tumors including adenomas and hepatocellular carcinoma. The onset is usually insidious with development of nausea, fatigue and itching followed by dark urine and jaundice. Liver effects are almost exclusive to oral steroids (or Alkylated steroirds). This is because Alkylation of the steroid allows it to survive the first pass through the liver but comes with a hepatoxic side effect. To protect your liver you should keep your oral intake to a maximum of 6 weeks with a 12 week gap (twice as long as your oral cycle) before you take more. Milk thistle or liver support tablets such as Liv-52 whilst on cycle should help protect your liver whilst staying off alcohol as well is a no-brainer.

The extra hormonal input can have a large impact on your mental state. A number of users suggest an amplify effect where the steroids will magnify your good or bad mood outside your normal boundaries. The extra testosterone will give heightened sense of invulnerability and aggression, whilst the extra oestrogen will make you cry at sad movies and be more emotional generally. Your mood swings are a natural result of the additional levels of the two hormones. Most people can deal with this with no problems, but you can try vitamin B6 (Pyriodoxal 5 Phosphate), L-Tyrosine (amino acid) or L-Tryptophan (amino acid), which assist in keeping the brain function in a relaxed state. If the issue gets worse see a doctor for some proscribed anti-depressants and its worth noting that heavy stacks seem to have the most profound impact on mood swings so reducing dosages is always an option.

Mood swings

mood

Osteoporosis

osteo

This is an extremely rare side effect and is almost entirely caused by misuse. Testosterone and oestrogen both play important roles in the breakdown and repair of bones and a strong imbalance here may cause osteoporosis particularly in Women. A good PCT program after every cycle to keep your body producing testosterone naturally and not overdosing on the AI will be more than enough to avoid any symptoms but as I said it is extremely rare. Generally Osteoporosis is wrongly attributed to anabolic steroids because it is in fact a common side effect of Corticosteroids.

The increased hormones from steroids can have effects on the mind. Although it is not well understood it is believed to exasperate any pre-existing mental conditions you may have. Tren in particular is infamous for its psychological side effects. Users sometimes feel paranoid like their girlfriend is cheating on them, people are talking about them behind their backs or that someone is constantly watching them. If you ever feel anxious, jealous, paranoid, have anger issues, mood swings (be honest here as well) before you take steroids then you need to be monitoring your mental health whilst on it. Even just being aware there may be changes is a good place to start and getting someone you trust to give you feedback on cycle is a good idea. If you start becoming paranoid to the point it is affecting your life, reduce your doses and cycle something different next time. If it becomes really serious see a mental health professional who may proscribe anti-depressants or something similar to reduce your sides. In almost all cases the sides will disappear once you finish your cycle.

Paranoia Exasperate

paranoia

Prostate Enlargement

prostate

BPH (Benign Prostate Hyperplasia) is enlargement of the prostate, that usually effects only older men. But, if you use steroids for years, then BPH may also affect you. Getting BPH from steroids, would depend on how susceptible you are and how long you have used Steroids. Many users of steroids notice a enlarging of their prostate after a while on cycle, making it slightly more difficult to urinate. There is controversy over what really causes BPH naturally in men, but DHT is thought to be just one possible component. DHT is converted from testosterone in the body and is 3.5 times more androgenic than testosterone. DHT is what gives men their masculinizing sex effects on the body. All androgenic steroids stimulate the same receptors on the prostate (to various degrees called the androgenic to anabolic ratio) in the same way DHT does.

Another mechanism by which BPH might be caused from steroid use, is due to low testosterone levels post cycle. Low testosterone levels and high estrogen, like as seen with post cycle and hypo gonadal men, can actually cause BPH. Many men have had a reduction in BPH when they were treated clinically with testosterone replacement therapy for low testosterone. The prostate usually shrinks back eventually after a steroid cycle, once your testosterone levels get back to normal.

If you are having trouble urinating as a result, Flowmax is an awesome product that should reduce the swelling sufficiently but any of its competitors work well also.

There is a strong link between testosterone levels and sleep. In a twist of irony low testosterone is equally as bad on sleep so it appears that sleep is somewhat dependant on maintaining a hormonal balance. Others have suggested that it also has a stimulating effect on your CNS (central nervous system), which makes it hard to fall asleep or that another side effect such as high blood pressure may be the cause of sleeplessness. Good news is that the effects generally subside over time as your body gets use to the changes. On a purely natural note; sex (or masturbation) and 20 minutes of stretching helps the body relax for sleep and are an easy (and fun) option to try. There are literally thousands of sleeping aids available as well if you need some medicinal help, it’s a matter of trial and error for each individual.

Sleeplessness

sleep

Stomach Problems

stomach

Orals can cause stomach issues in some users. Common problems include diarrhea, nausea, dyspepsia (indigestion), reduced appetite and possibly stomach ulcers (although it is strongly debated). Injectables bypass the stomach completely and seem to have little to no effect whatsoever on your stomach. Your first option is to avoid orals completely if they are giving you trouble. Other options include taking orals with food or with an antacid, which will help reduce symptoms, as will probiotics and digestive enzymes for maintaining stomach flora. Lastly see your doctor if the symptoms persist or are severe. If you have blood in your stool then it might be a stomach ulcer, which as mentioned before may not be caused by the orals but certainly isn’t helped by them.

While injecting test increases protein synthesis by roughly 50 times, depending on dose and time, most bodybuilders forget that it will reduce collagen synthesis by more than 50% — possibly up to 80%, giving you the collagen synthesis rate of a senior citizen. Since collagen makes up tendons, you are more prone to injury as you adjust to more muscle mass, heavier lifts and weaker tendons. Having said that it is incredibly rare still but there are some things you can do.First lift with proper technique. You should be doing this already but poor form, weaker tendons and heavier weights are a bad combination. Secondly you can take a collagen supplement or at least an omega 3 supplement to help your collagen production. Lastly some good steroids to stack that increase collagen synthesis in a big way include Deca, Primobolan, Equipoise and Oxandrolone.

Tendon Rupture

tendon

Testicular Damage

testes

The hypothalamus in the human brain has a detection mechanism, which regulates the release of many hormones responsible for controlling the production of androgens by the testes and the adrenal glands. Steroids cause abnormally high levels of these hormones in the body and your brain instructs your testes to stop further production of androgens as a result. Basically your testes will continue to be dormant whilst there are elevated levels of hormones in the body (on cycle) and will shrink known as testicular atrophy as well as possible erectile dysfunction. In almost all cases this is temporary and during your off-cycle your testes and androgen production will return to normal.

However HCG during your cycle can minimise the effects and taken it in your PCT will definitely return your testes to their normal productive state. If you are having severe effects during cycle then two products that work really well are Tamoxifen and Chrysin and should be used if you have concerns.

The fluid retention you get on cycle is due to excess estrogen from any aromatizable steroids such as Dbol and Test . Excess estrogen increases reabsorption of sodium salts and water by the kidney, which is the cause of the bloating. Of course this is only temporary and should disappear post cycle.If you want to manage your bloating then a good AI (Aromatase inhibitor) on cycle will help, whilst diuretics are known to help as well. . Also I estimate that 90% of people with bloating issues have too much sodium in the diet, so if you are not monitoring your sodium intake I can guarantee you are getting too much. So double check your diet and look at your sodium intake this will make a huge difference for most people. Lastly and somewhat counter-intuitively make sure you are drinking enough water. Too many people reduce their intake when they see bloating but if you are not getting enough water your body will store what water you get as a survival mechanism so make sure you drink a couple of litres a day.

Water-retention (bloating)

water

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