Anabolic Steroids and Corticosteroids: How They Differ

Corticosteroids refer to a class of drug used to treat inflammatory arthritis and other inflammatory conditions. Because they are commonly referred to as "steroids," people will often believe them to be the same thing as anabolic steroids which are used boost strength and physical performance.

The word "steroid" is a broad-ranging term used to describe any compound with a specific molecular structure (comprised of four fused rings of 17 carbon atoms). The function of steroids is to either maintain the integrity of a cell's membrane or to activate a receptor on a cell's surface to regulate how it behaves.

There are many different types of steroid found in nature, broadly classified as:

• Sex steroids, including estrogen, progesterone, and testosterone
• Corticosteroids, including glucocorticoids (such as cortisol) which regulates the immune function and mineralocorticoids (such as aldosterone) which regulates the balance of electrolytes
• Secosteroids such as vitamin D which helps regulate numerous biological functions
• Neurosteroids such as DHEA which aid in the synthesis of male and female hormones
• Sterols such as cholesterol which help maintain cell membrane integrity

Anabolic steroids are synthetic variations of natural male sex hormones (androgens). They are used to promote the growth of skeletal muscle (the anabolic effect) and the development of male sexual characteristics (the androgenic effect).

Anabolic steroids are available by prescription and are used to treat conditions that result in abnormally low testosterone levels (hypogonadism). The causes may include undescended testicles, testicle injury, hemochromatosis (excessive iron in the blood), pituitary disorders, inflammatory diseases, obesity, and advanced HIV infection.

Because of their anabolic effect, the drugs are often abused by athletes or persons wanting to improve their physical appearance. The long-term abuse of anabolic steroids can lead to serious health consequences, including:

• Severe acne
• Development of breast in men (gynecomastia)
• Facial and body hair growth in women (hirsutism)
• High blood pressure
• Dramatic mood changes ("roid rages")
• Manic behavior
• Shrinkage of testicles
• Male pattern baldness in both sexes
• Irregular menstruation
• Infertility
• Yellowing of the eyes or skin (jaundice)
• Tendon rupture
• Liver tumors or cancer
• Stunted growth in youth

Corticosteroids refer to either naturally occurring compounds produced by the adrenal cortex or synthetic versions that mirror their molecular structure. Corticosteroids act on the immune system by blocking the production of substances that trigger allergic and inflammatory responses.

The drugs can be delivered orally, nasally, topically, or by injection to treat such health conditions as allergies, Crohn's disease, ulcerative colitis, autoimmune disorders (such as rheumatoid arthritis or lupus), blood disorders (such as lymphoma and leukemia), and prostate cancer.

The corticosteroid drugs commonly prescribed in the U.S. include:

• Betamethasone
• Budesonide
• Cortisone
• Dexamethasone
• Hydrocortisone
• Methylprednisolone
• Prednisolone
• Prednisone
• Triamcinolone

The drugs are available under various brand names and formulations.

Corticosteroids are powerful drugs that can quickly reduce inflammation while enhancing recovery. With that being said, the overuse of the drugs can cause serious and sometimes contradictory side effects, including:

• Weight gain
• Acne
• Muscle weakness
• Thinning of the skin
• Redistribution of body fat (lipodystrophy)
• Tendon rupture
• Hypertension
• Diabetes
• Osteoporosis
• Cataracts
• Increased susceptibility to infection
• Stomach ulcers
• Depression

To maximize benefits, corticosteroids are prescribed in the lowest possible dose over the shortest period of time to achieve the best possible outcome.

If used for longer periods, the drugs must be gradually tapered off to allow the adrenal gland to gradually take over its normal function. Stopping too quickly can result in withdrawal symptoms and a potentially life-threatening adrenal crisis.

If your treatment plan involves the use of corticosteroid drugs, always weigh the benefits and risks with your doctor. Depending on your health status, there may be other options that can deliver the same relief with far less risk.

In the end, it is often best to reserve corticosteroids for later use when the need for the drugs may be far greater.