All steroids are of great importance in medicine, as well as in veterinary medicine. Steroids are used as anti-inflammatory, anti-allergic, and immunosuppressive drugs. This is only a small part of the huge spectrum of steroids’ influence on the human body.
WHAT ARE STEROIDS?
Steroids, chemically are compounds derived from sterane or cyclopentanoperhydrophenanthrene. When represented graphically as 3 hexagonal carbonaceous rings and a pentagonal ring, for a total of 18 carbons.
From the biological point of view, the most common derivative of sterane is cholesterol. It is a sterane to which a hydroxyl (-OH) has been added in position 3 of the first ring (C3) and a carbonaceous branch in the last carbon of the last ring (C17).
It is an integral and fundamental part of numerous structures. Such as the phospholipid bilayer of the cell membrane and the myelin sheaths of neurons (white matter).
Cholesterol derives from a long process of condensation of carbonaceous units. Which originate from the key molecule of energy processes, acetyl-coenzyme A.
Cholesterol is also the basis for the synthesis of steroid hormones. Such as testosterone, estradiol, cortisone, cortisol, aldosterone, and vitamin D3. It is also a precursor of acids/bile salts, which are the main method of “excretion” of cholesterol from the body.
Steroids are therefore derivatives of cholesterol, they share the basic steranic structure. But have one or more modifications in the bonds of the rings (common is the removal of the C17 chain, often replaced by hydroxyls or ketones), which completely modify their biological activity.
STEROIDS: WHAT FUNCTIONS DO THEY PERFORM?
In general, we can say that the most common medical use for steroids is anti-inflammatory. Immunosuppressive for cortisol derivatives, androgen replacement therapy for androgens (mostly testosterone), or various anabolics in cases of sarcopenia or cachexia (cancer and anticlastic therapy, aging, HIV infection, severe trauma, and extensive burns …)
Here is a shortlist of their functions, including several present, past, and future uses:
- Muscle protein synthesis, prevention, and treatment of sarcopenia, cachexia, hypermetabolic states induced by conditions or diseases (AAS)
- Hormone Replacement Therapy for Hypogonadism or Transsexuals (AAS, Estrogen)
- Treatment of various forms of anemia and inappetence (AAS)
- Prevention and treatment of osteoporosis, post-menopausal disorders (AAS, Estrogens)
- Cancer therapy (AAS, Estrogens, Glucocorticoids)
- Autoimmune diseases, chronic inflammations (Glucocorticoids)
- Hormonal contraceptives (AAS, Estrogens, Progestogens)
- Livestock breeding (prohibited in the EU) and veterinary use (AAS, Progestogens, Estrogens, Glucocorticoids)
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HOW ARE STEROIDS TAKEN?
Steroids and derivatives are molecules generally not very soluble in water and very soluble in non-polar liquids (such as oil).
IM / SC INJECTIONS
The preferable administration is parenteral in the form of intramuscular (IM). Sometimes subcutaneous (SC) injection, ensuring maximum bioavailability and little or no hepatic toxicity. They are often esterified in C17 beta in order to decrease their polarity further. Slow their release into the circulation and prolong it for days, weeks, or months (like testosterone preparations for replacement therapy). Widely used for AAS and corticosteroids. If you are looking for injectable steroids, you have to buy steroids online.
For replacement therapies in hypogonadism, the transdermal route is widely used; the steroid is solubilized in an alcoholic gel or patch that is applied to the skin, the alcohol evaporates, and the steroid is absorbed which is gradually released from the skin deposit in about 24 hours. Bioavailability is poorer, around 10% but is more accepted by patients than injections. Corticosteroids and estrogens/progestogens are also available in topical preparations for the same reasons.
Oral administration takes place for particular modified synthetic steroids with the addition of methyl groups in C17 alpha (alpha refers to the position of the radical with respect to the carbon plane), which modifies the structure of the molecule, making it resistant to the first intestinal and hepatic passage, to the detriment of significant liver toxicity. For orally consumable steroids, you should buy steroids online.
Non-alpha alkylated steroids are also administered orally when a high bioavailability is not required (or one is willing to sacrifice it) (contraceptives, synthetic glucocorticoids, testosterone undecanoate softgel).
STEROIDS AS A CURE
In this case, it is convenient to distinguish three types of steroids with sometimes opposite functions, but often used to treat pathologies in medicine:
Corticosteroids or glucocorticoids
Often in medical jargon, when speaking of steroid therapy, it refers to synthetic corticosteroids, used to suppress severe, widespread, or chronic inflammatory states (rheumatic diseases, asthma, obstructive bronchopneumonia, glomerulonephritis …) autoimmune reactions (arthritis, lupus, organ transplants ), sometimes also as antiemetics and appetite stimulators (for example in cancer therapy) or as hormone replacement therapy in rare genetic or acquired diseases (Addison’s disease).
From the anti-inflammatory point of view, they differ from classic NSAIDs (such as aspirin and ibuprofen) because the latter act at the level of COX, enzymes that synthesize inflammatory prostaglandins starting from arachidonic acid, while glucocorticoids act upstream, at the level of phospholipases (inhibiting them) which release arachidonic acid; they are also powerful immunosuppressants that inhibit the activity of white cells (very useful in autoimmune diseases or chronic inflammation).
The androgenic/anabolic steroids (AAS), on the other hand, are testosterone and synthetic derivatives, are mainly used for hormone replacement therapy in male hypogonadism, where for various reasons there is an androgenic deficiency.
Other uses are in cases of psychophysical wasting (which often coincides with delayed onset hypogonadism, LOH), as supportive anabolic or palliative oncological therapy (end-stage tumors, to improve the quality of life of patients).
Doping in the gym and bodybuilding
Steroids are commonly and legally considered to be performance-enhancing drugs; if you consult the WADA anti-doping list (list of prohibited substances and methods), we find anabolic and non-anabolic steroids. As well as numerous other drugs such as beta-agonists, narcotics, synthetic/human peptides, human/recombinant hormones, THC, opiates/opioids, diuretics, amphetamines, blood autotransfusions, etc.
Anabolic steroids confer a clear advantage in terms of performance and recovery from both training and injuries; however, putting the athlete’s health at risk and making the competition unfair for those who do not use substances.
Depending on the type of steroid used, there are different detection times, extremely variable from person to person. In the event of a positive test, there can be serious legal consequences as well as the penalties and measures established by anti-doping.
For example, a single injection of nandrolone (150mg) is detectable up to 9 months while a testosterone injection (200-300mg) may not be detectable . Even when taking it in all subjects according to the WADA criteria, which plan to evaluate the ratio between Testosterone and Epitestosterone conjugates (6-4: 1), as the latter is a metabolite that is produced regardless of the doses administered.
Paradoxically, there are people who have impaired testosterone metabolism and are found to cross the line without taking exogenous testosterone.
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