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Transcript for Podcast: Coming Off Anabolic Steroids: Dangers, Realities & Rewards

We live in a culture that places a premium on athletic performance and personal appearance. Athletes act as role models for youth and adults alike. A fit, toned, and muscular body is held up as the ideal in our society; reinforced by TV and the print media. One major reason people exercise is to look fit and feel better about themselves. But this healthy impulse can be taken to an unhealthy extreme when accompanied by the abuse of anabolic-androgenic steroids.

Anabolic steroids are used by athletes and other individuals to enhance their physical performance and improve their appearance by increasing muscle size or reducing body fat. They can be taken orally or injected, usually in cycles of several weeks of use followed by several weeks of non-use, and then use again in repeated cycles lasting 6 to 12 weeks. Sometimes, people take several different types of steroids, a practice known as stacking. Another common practice is pyramiding, in which users slowly ramp up their steroid abuse by increasing the number of steroids or the dose and frequency of steroids, reaching a peak at mid-cycle, and then gradually tapering down at the end of the cycle.

While steroids can be addictive, they do not cause a state of euphoria like other drugs of abuse. However, long-term use of steroids can impact some of the same brain pathways and chemicals that are influenced by illicit drug use. Because of this, steroids can affect mood and behavior in significant ways. These include aggression, extreme mood swings, and manic-like symptoms that can cause violence. Steroid abusers may also experience paranoid delusions, extreme irritability, and impaired judgment due to feelings of invincibility.

Because of their addictive potential, individuals may experience withdrawal symptoms when they stop taking steroids. These include fatigue, restlessness, loss of appetite, insomnia, and steroid cravings. One of the most dangerous withdrawal symptoms is depression, which can sometimes lead to suicide attempts.

In addition to psychological changes, steroid abuse causes serious health problems, some of which are irreversible. The most dangerous include liver damage, high blood pressure, stroke, heart attack, and kidney failure. Some health side effects are gender or age-specific. For example, men may experience shrinking of the testicles, reduced sperm count, and development of breasts. Women may notice growth of facial hair, changes in menstrual cycle, or male pattern baldness. Adolescents may experience stunted growth and accelerated pubertal changes.

There is plenty of evidence that prolonged steroid abuse is harmful. Yet little research has been conducted about the best ways to come off steroids. If you decide you want to call it quits, there are several things to keep in mind. The first is that coming off of steroids takes planning. If you’ve been taking them for a while, and especially if you’ve been stacking or pyramiding, it’s best not to go “cold turkey” because of a phenomenon known as the bridge.

The “bridge” is a term used to describe the gap in time from when anabolic steroids are eliminated from your system, to when your body starts producing natural testosterone. During this time there is a shift in the hormonal balance between estrogen and testosterone, in which estrogen (the female hormone) is elevated and testosterone production is very low or nonexistent. Medical assistance and the use of prescribed medications can make this transition more manageable by eliminating or significantly reducing this timeframe, as well as minimizing the number and severity of potential side effects. Your doctor will use blood tests to properly dose medicine and further assess internal damage. After thoroughly evaluating your condition, your doctor may recommend immediate discontinuation, or more likely, a gradual tapering of drugs to permit the body to normalize slowly.

When seeking a doctor’s help with coming off steroids, it’s essential to pull together information about your steroid use. It’s also important to be open and honest regarding every aspect of your steroid history including: all of the drugs you’ve taken (including both steroids & ancillaries drugs); the length of time you’ve used steroids; your dosages & scheduling habits; and any physical & mental side effects you’ve experienced. Since anabolic steroids are sold under many names, made in several countries, and usually purchased on the black market, it’s recommended that you bring a list of all of the products taken, and if possible the actual containers you purchased them in.

When coming off of a steroid regimen people should also alter their diet and nutritional intake. Calories should be decreased by about one-quarter to one-third over a number of days without altering protein intake as much.

If you have a very demanding exercise and workout regimen, this also should be decreased, because your body won’t be able to maintain the same level of training while coming off of the steroids. People reducing their steroid intake should not try to compensate by increasing the intensity of their exercise regimens. It simply won’t work. On the other hand, eliminating physical activity entirely when coming off steroids is also not a good idea. Physical training is needed during this time to keep endorphins high in order to stave off depression, to help you maintain a healthy cardiovascular system, and to maintain your general physical health.

Counseling, therapy, and substance use support groups may be helpful in stopping steroid use. You may need to address body image issues since many people start using steroids with their workouts because they feel badly about their personal appearance. A person going off steroids may also need to make lifestyle changes to maintain abstinence. This might involve switching gyms, finding new workout partners, choosing different competitive events, or changing sports. A person stopping steroids may benefit from specialists who can help them develop healthy fitness regimens that are independent of steroid use.

There are a number of free resources that are available to people who want to stop abusing steroids. One is the website of the Association Against Steroid Abuse at They have a number of helpful pages such as How to Spot a Steroid Abuser, Steroid Use in High School, How to Come Off Steroids, Peer Pressure and Steroids, True Stories and Videos about steroid abuse. For adolescents, the ATLAS and ATHENA programs help young men and women learn about the dangers of steroid use and how to select healthy exercise and nutrition alternatives. You can find out about these award winning programs at the web site at Finally, fact sheets on the health effects of anabolic steroids are available on the National Institute on Drug Abuse website or by calling the National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686.

Remember, the longer you stay on steroids the harder it is to get off. The health risks are real and many are not reversible. In the words of Hugo Rivera, a top level competitive national bodybuilder:

“Building the body is a lifetime commitment that has to be practiced eagerly day in and day out with the utmost persistence. There are no shortcuts to a championship body; not even steroids.”

Check out Rivera’s blog about steroid abuse and effective alternatives by going to the website, clicking on the tab “Explore Topics” and then selecting Bodybuilding.

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