Anabolic steroid use linked to long-lasting heart problems

Anabolic steroids can continue causing serious side effects years after users stop taking them, two new studies suggest.

The synthetic derivatives of testosterone have become popular among athletes and bodybuilders who want to improve their performance and develop a more muscular physique.

In most countries, they are only available legally for personal use on prescription from a registered pharmacist. But there has in recent years been an explosion of the black market for illegal anabolic steroids as their use has extended out into the general population, especially among body-conscious young men looking to improve their appearance.

Men in their 40s, 50s, and even into their 60s and 70s are also increasingly turning to steroids that mimic the naturally-occurring sex hormone testosterone, in a bid to fight the signs of ageing and boost their libido.

Anabolic steroid use is known to cause a host of severe health problems, however, from early heart attacks to kidney and liver failure, strokes, and psychiatric issues, as well as lower testosterone levels, erectile dysfunction, breast growth, and hair loss.

Not much has been known about their effect on users years after they stop taking them, though.

But according to the two studies presented at the 25th European Congress of Endocrinology in Istanbul, steroids could be linked to long-lasting heart disease and a worse quality of life.

These studies were carried out by researchers from the Copenhagen University Hospital Rigshospitalet who investigated the impact of anabolic steroids in former users.

In one study, the researchers examined 64 healthy men aged between 18 and 50, who did recreational strength training in Denmark.

Of these men, 28 were using anabolic steroids, 22 were former users, and 14 had never taken the manufactured drugs, first synthesised in Germany in 1935 and initially utilised by the medical profession to treat depression, before professional Russian weightlifters began misusing them in the early 1950s.

The researchers assessed how much blood flowed to their heart muscle when resting and exercising, using a Positron Emission Tomography-Computed Tomography (PET-CT) scan with the radioactive tracer Rubidium-82. They found both former and current users had a poor blood flow to the heart.

The findings indicate that former steroid users are more likely to develop heart disease when compared to those who have never used them.

Lead author Dr Yeliz Bulut, a Phd student at the Rigshospitalet, said: “Previous studies have shown that the heart function almost normalises after anabolic steroids are discontinued, but our study suggests that former anabolic steroid users are at an increased risk of heart disease years after stopping as cardiac microcirculation – the blood flow through the smallest vessels in the circulatory system – seems persistently impaired.

“The previous use of anabolic steroids could be a new risk factor for developing cardiovascular disease.”

In another study, Dr Bulut and colleagues collected questionnaires and blood samples to measure testosterone levels from three groups of men, aged 18-50 years. The group included 89 current anabolic steroid users, 61 former, and 30 men who had never used the drugs before.

They found that former users of anabolic steroids reported a worse quality of life on their physical and mental health, such as fatigue, social functioning and emotional well-being, despite stopping years earlier.

Additionally, the same group had lower testosterone levels compared to those who had never used steroids.

Previous studies have shown that men experience withdrawal symptoms, such as depression and decreased motivation, and have lower levels of testosterone, immediately after they stop using steroids.

“Our study adds to the growing body of literature that an impaired quality of life in previous anabolic steroid users seems to persist years following cessation and could be caused by both withdrawal and/or hypogonadal symptoms due to a sudden drop in testosterone levels in the blood,” Dr Bulut explained.

“Sadly, a reported worse quality of life could be a reason for former users to start reusing these steroids again.”

Both studies included a small number of anabolic steroid users, former users and non-users.

Dr Bulut and her team now plan to recruit more men to the studies to assess both of these links with former steroid abuse on a larger scale.

“Our initial findings show that previous anabolic steroid users are likely to develop heart disease and have a decreased quality of life but we need to confirm these results with larger studies and investigate how the risk changes in relation to the years of usage and/ or cessation.

“Steroid side effects among former users seem to persist for a much longer period than we have known until now. We hope our results on these long-term health risks will prevent men from using anabolic androgenic-steroids.”