Prednisone Abuse versus Anabolic Steroid Abuse

Human adrenal glands primarily secrete 3 types of hormones: mineralocorticoids (that maintain serum concentration of sodium, potassium and other hormones), glucocorticoids (that are released during stressful events to prepare the body to fight infections), and androgens (that are required to enhance secondary sexual characteristics and mimic testosterone in action). Excess secretion of androgens can lead to:

• Improvement in muscle power and strength.
• Increased production of proteins by the body, leading to an overall gain in muscle mass.
• Higher athletic endurance and muscular performance.
• Increase in basal/resting metabolism to minimize the deposition of fat, and increase of energy levels by fat oxidation for the generation of energy.

Anabolic steroids are mainly synthetic analogues of androgens (just as prednisone is a synthetic analogue of glucocorticoids).

What is Steroid Abuse and How is it Different From Prednisone Abuse?

It has been observed that some individuals abuse prednisone by increasing the dosage and duration of their prescription; however, it is important to highlight that prednisone is different from anabolic steroids (or exogenous androgens) that are consumed by athletes, bodybuilders and weightlifters to increase muscle mass in a short period of time.

Intentional abuse of prednisone is less common, since prednisone intake is not associated with notably positive or pleasurable effects. On the other hand, anabolic steroid abuse is fairly common in the general population, and according to latest estimates, approximately 10.2% of all male athletes consume anabolic steroids on a regular basis. The small percentage of individuals who abuse prednisone intentionally may confuse it with anabolic steroids.

What are the Hazards of Anabolic Steroid Abuse?

It may seem like a good idea to try to take a shortcut to a toned and muscular body with the help of anabolic steroids or androgens instead of using traditional methods like resistance training and gym exercises, but long-term steroid abuse is ultimately harmful for the body and may lead to these complications:

• Hypogonadism (regression of external genitalia)
• Infertility due to reduction in sperm production
• Gynecomastia (or development of breast tissue)
• Loss of hair (patchiness or complete baldness)

In females, anabolic steroid abuse leads to increased muscle mass and other masculine characteristics like male pattern hair loss, deepening of the voice, enlargement of female external genitalia, acne and appearance of facial hair.

Long- term complications of steroid abuse can lead to major health issues like:

• Liver failure
• Higher risk of developing blood clots that may impede blood flow to certain major tissues
• 40% elevated risk of suffering stroke and 55% higher risk of suffering heart attack
• Liver cancer
• Permanent closure of bone cartilage in adolescents

What are the Hazards of Prednisone Abuse?

Individuals who abuse prednisone are at higher risk of developing these complications:

• Loss of bone mineral density and an increased risk of developing fractures
• Loss of muscle mass
• Fatigue and low energy levels
• Loss of muscle strength and power
• Impaired blood sugar concentration and deposition of fat
• Moon face and other features of Cushing's syndrome

In a nutshell, abuse of anabolic steroids or prednisone (or other types of steroids) increases the risk of complications in the long run. It is recommended to educate young adolescents and athletes regarding potential side effects of anabolic steroids and prednisone to minimize the risk of long-term abuse and complications developing.

References:

1. Buckley, W. E., Yesalis III, C. E., Friedl, K. E., Anderson, W. A., Streit, A. L., & Wright, J. E. (1988). Estimated prevalence of anabolic steroid use among male high school seniors. JAMA: the journal of the American Medical Association, 260(23), 3441-3445.
2. Korkia, P., & Stimson, G. V. (1997). Indications of prevalence, practice and effects of anabolic steroid use in Great Britain. International Journal of Sports Medicine, 18(07), 557-562.
3. DuRant, R. H., Escobedo, L. G., & Heath, G. W. (1995). Anabolic-steroid use, strength training, and multiple drug use among adolescents in the United States. Pediatrics, 96(1), 23-28.
4. Hall, R. C., Hall, R. C., & Chapman, M. J. (2005). Psychiatric complications of anabolic steroid abuse. Psychosomatics, 46(4), 285-290.