Steroid side effects in adults
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Steroid Side Effects in Adults
Steroids, including anabolic-androgenic steroids (AAS) and corticosteroids, are widely used for various medical and non-medical purposes. However, their use is associated with a range of side effects that can impact multiple body systems. This article synthesizes the findings from several research studies to provide a comprehensive overview of the side effects of steroid use in adults.
Anabolic-Androgenic Steroids (AAS) Side Effects
Muscular and Cardiovascular Effects
Anabolic-androgenic steroids are often used by athletes to enhance muscle strength and lean mass. Studies have shown that AAS use results in a small increase in muscle strength and a moderate increase in lean mass . However, these benefits come with significant adverse effects. AAS use is associated with increased low-density lipoprotein (LDL) and decreased high-density lipoprotein (HDL), which can lead to cardiovascular issues such as hypertension Andrews2018Walter2023.
Reproductive and Metabolic Effects
AAS negatively affect the male reproductive system by impairing sperm production and reducing endogenous testosterone production. This can lead to conditions such as gynecomastia, hair loss, and sexual dysfunction . Additionally, AAS use is linked to a worse metabolic profile, characterized by increased LDL cholesterol levels and a higher risk of hypertension .
Neuropsychiatric and Dermatological Effects
Neuropsychiatric side effects of AAS include irritability and mood disturbances. Dermatological issues such as acne are also commonly reported among AAS users Andrews2018Walter2023.
Corticosteroids Side Effects
Short-Term and Long-Term Effects
Corticosteroids like dexamethasone are used for various medical conditions, including inflammation and autoimmune diseases. Short-term use can lead to side effects such as hyperglycemia, increased infection risk, and hypertension Polderman2015Travis2008. Long-term use is associated with more severe side effects, including osteoporosis, cataracts, and adrenal insufficiency .
Postoperative Effects
In surgical patients, a single dose of dexamethasone does not significantly increase the risk of postoperative infections but may cause a mild increase in blood glucose levels, particularly in patients with diabetes . The effects on wound healing are unclear due to the variability in study results .
Psychosis and Withdrawal
Steroid-induced psychosis, although rare, can occur in both adults and children. Symptoms include hallucinations and delusions, which typically resolve after discontinuation of the steroid . Withdrawal from corticosteroids can also lead to acute adrenal insufficiency and a syndrome resembling a flare-up of the underlying disease .
Steroid-Associated Adverse Events in Specific Conditions
Kidney Disease
In patients with primary proteinuric kidney disease, steroid therapy is associated with a high incidence of adverse events such as hypertension, diabetes, obesity, and infections. The risk of these side effects increases with higher doses of steroids .
Topical Corticosteroids
Topical corticosteroid withdrawal, also known as "steroid addiction," is a distinct clinical condition characterized by burning, stinging, and erythema, primarily affecting the face and genital areas. This condition is often the result of long-term inappropriate use of potent topical corticosteroids .
Conclusion
While steroids can provide significant therapeutic benefits, their use is associated with a wide range of side effects that can impact multiple body systems. Both anabolic-androgenic steroids and corticosteroids have their own sets of adverse effects, which can be severe and long-lasting. It is crucial for healthcare providers to monitor patients closely and consider steroid-sparing alternatives whenever possible to minimize these risks.
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