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The juice is loose.

April 14, 2007

Matthew Vasey, MD

There isn't much data in the medical literature proving that "the juice", or anabolic steroids enhance athletic performance. (7) That doesn't mean you don't just have to turn on ESPN to catch the latest buzz on which premiere athlete has controversially, made their way to the top to see that anabolic steroids can actually enhance athletic performance.

A teenager has the right to believe that he or she will be the next seven figure salaried professional athlete. It is probably safe to assume that at some point, we have all dreamed of making millions as a professional athlete. This would explain why an estimated 4-12% of high school boys have experimented with anabolic steroids at sometime in their life (6). While getting a scholarship or even a professional draft pick may enter into the picture with steroid use, now too have potential cardiovascular (heart), hepatic (liver), reproductive/endocrine ("genitals") and psychiatric (personality) dangers.

Heart: Unpredictable changes in the fat content of your blood stream. (4) This fat in your blood clogs little vessels which are about the size of a coffee stirring straws that wrap around your heart. If one of those vessels gets narrowed from fat accumulation, the next time your intensely exercise your heart, enough blood won't be able to pass through and you have a heart attack.

Liver: The medical literature clearly documents a transient, or temporary effect of steroids on liver function tests (5) This is why steroid users, use in "cycles" (1) There have been cases of liver cancer in high dose steroid users. (2) Liver cancer kills.

Genitals: This is true. Anabolic steroids can result in what is called "testicular atrophy". The reason is because testicles provide your body with the steroids that it makes on its own. When your brain detects levels of steroids in your blood that are higher that what is normal secondary to injection or pills, the brain stops telling your testicles to make steroids because it has enough. As their function is needed less and less by your body, they reduce in size. There are other effects as well, such as a voice getting higher and developing gynecomastia or male breasts because of a compensatory rise in estrogen. A major hormone involved in female devolpment.

Mind: There isn't much proof of this in humans given, I suppose, given the difficulties of creating a research study of this nature. There have been individual instances in people and animal studies published relating "rages" with anabolic steroids. (3)

In the seemingly, never ending saga of professional athletes and performance enhancing drugs it is important to keep things in perspective and weigh the risks and benefits of every health related decision you make. This is particularly of importance in the youthful audience.


1. Blue J, Lombardo J. Steroids and steroid-like compounds. Clin Sports Med 1999;18:667-689.
2. Brown J. Anabolic steroids: what should the emergency physician know? Emerg Med Clin N Am. 2005;23:815-826.
3. Conacher G, Workman D. Violent crime possibly associated with anabolic steroid use. Am J Psychiatry. 1989;145:679.
4. Duchaine D. Underground steroid handbook II. Venice (CA): HLR Technical Books; 1989.
5. Ishak K, Zimmerman H. Hepatotoxic effects of the anabolic/androgenic steroids. Semin Liver Sis. 1987;7:230-236.
6. Yates W, Perry G, Anderson K. Illicit anabolic steroid use: a controlled personality study. Acta Psychiatr Scand. 1990;81:548-550.
7. Yesalis C, Bahrke M. Anabolic-androgenic steroids: current issues. Sports Med. 1995;19:326-340. on Social Media