What are steroids?

Anabolic-androgenic steroids are powerful prescription drugs that some athletes use not for medical reasons but as a way to boost athletic performance and build muscle and body mass. They may be called steroids, roids, juice, hype, or pump. They work by acting like the body's natural male hormone, testosterone. Some people confuse them with corticosteroids, which are a very different type of steroid used to treat diseases like asthma, arthritis, and other medical conditions.

Steroids can be taken by mouth (pills), by injection, or on a patch placed onto the skin. Some athletes take very large doses, called "megadoses." Others increase how much they take over time, called "pyramiding." Some "cycle" on and off steroids. Taking different kinds of steroids together, sometimes with other drugs, is called "stacking."

Steroid use is dangerous, so it has been banned by most professional and amateur athletic organizations. These organizations include the International Olympic Committee, National Collegiate Athletic Association, and National Football League.

How are steroids harmful?

Steroid use always causes bad side effects. They can really mess up your body. Megadoses do not give faster results, and using in cycles is not safer. Stacking is dangerous. Even though some of the side effects go away when you stop using steroids, some may not. Side effects for teens of any sex include

• Acne, especially on the face and back

• Baldness

• High blood pressure, unhealthy cholesterol, and heart disease

• Blood clots and stroke

• Sleep problems

• Liver damage or liver cancer

• Headaches, aching joints, and muscle cramps

• Nausea, vomiting, and diarrhea

• Slowdown of growth in athletes who are still developing

• Increased risk for ligament and tendon injuries

• Impotence (inability to get an erection) and breast and nipple growth (for teens assigned male at birth)

• Breast shrinkage, more face and body hair, and menstrual problems (for teens assigned female at birth)

• Harm to the mind and mental health, including

  • "Roid rage"—severe, aggressive behavior that may lead to fighting or destroying property

  • Severe mood swings

  • Hallucinations—seeing or hearing things that are not really there

  • Paranoia—extreme feelings of mistrust or fear

  • Anxiety and panic attacks

  • Depression and thoughts of suicide

Also, anyone injecting steroids with a needle and sharing needles with others is at higher risk for serious infections like hepatitis or HIV infection.

What are performance enhancers?

Besides steroids, some athletes use other substances that they think will make them better athletes. Some are illegal. All are unsafe. None can take the place of a good strength and conditioning program and a well-balanced diet. Some common "performance enhancers" and their known effects include

• Androstenedione (also called andro)—an over-the-counter supplement that claims to build muscle and increase strength (although scientific studies have shown it doesn't). It poses the same risks as steroids. Andro has been banned by most major sport organizations and the US Food and Drug Administration (FDA).

• Creatine—an over-the-counter supplement that claims to build muscle and bulk. Can cause muscle and stomach cramps and dehydration. While not legally banned, its use is prohibited by the National Collegiate Athletic Association.

• Ephedra—a supplement that claims to burn fat and help you lose weight. Can cause heart attacks, stroke, seizures, and sudden death. Banned by all major sports organizations and the FDA.

• Protein supplements—over-the-counter supplements that claim to build muscle and bulk. Can cause serious kidney problems from protein overload. Not banned at this time.

It is important to know that these substances are considered dietary supplements, so they are not approved by the FDA. That means they are not tested by the FDA to see if they really work or are safe.

Stay healthy

Keep in mind that athletic ability comes from a combination of things like your body size, age, gender, diet, and proper training—not just strength or muscle mass. Here are ways to stay healthy.

• Train, practice, and play safely (do not take drugs; wear protective gear; set realistic goals).

• Get training, coaching, and advice from reliable professionals.

• Eat and sleep well.

• Remember to schedule recommended health visits with your doctor. Ask questions, if you have them.

Visit www.HealthyChildren.org for more information.