What is steroid aromatization

When taking steroids, there are number of process that happens in the body. Along with anabolic effect, steroids may cause some serious side effects that every bodybuilder fears of. Most of them are estrogenic issues caused by the strong aromatization.

Bodybuilders search on the internet for low aromatizing steroids or even for those who do not aromatize at all. This is a wrong approach, since all steroids aromatize, but in different degree.

To better understand why all steroids carry the risk of aromatization and how bad it is for your health, you will have to know, first of all, what aromatization means, what cause it and how can be prevented its downsides. Yes, downsides, since generally it is good process for body and you will see in this article why.

Aromatization is not triggered by steroid use. It is a natural process during which testosterone is transformed into estrogen. This process is carried out by a special enzyme in our body called aromatase, thus the whole processed was called aromatization. The main task or aromatization is the synthesis of cholesterol and fats. But it changes when body feels a testosterone boost.

Human body has a very interesting characteristic: it tend to ensure a balance in all it has-muscles, hormones, temperature and others. This stage is known as homeostasis. When big amounts of testosterone enters the body, homeostasis try to put the things in order by triggering a stronger process of aromatization. This means that a big part of injected or swallowed testosterone is converted into estrogens, causing serious side effects like bitch tits, or also called gyno.

Each system has different number of aromatase enzymes. The higher is their number, the bigger is the percentage of testosterone who get into estrogen. Thereby, persons with big volume of aromatase enzymes can experience serious health issues even taking anabolic steroids even in smallest doses. Also, this group of bodybuilders have always to pay a bigger attention to antiestrogens drugs when going throughout a cycle.

Why our system has such a categorical reaction to high amounts of testosterone?

Normally a man body produce about 7 mg of testosterone per day. This is a quite modest dose, which not leads to massive muscle gains. Even try naturally, this level will increase but  you will need to put great efforts and much time on this. And efforts doesn’t mean to work hard in the gym only, but also to keep a close eyes to your nutritional diet and rest time.

It is more easier and convenient to get the testosterone level higher by taking steroids. Usually, one dose of steroid is at least 100 mg and higher. This means that suddenly high amounts of testosterone get into body, causing a serious hormonal disbalance.Our body react and try to keep a balance, and begin to convert the surplus of testosterone into estrogen.

So, the answer is that our body is accustomed to a certain amount of testosterone produced daily. It always keep a balance, that’s  why when big doses of synthetic testosterone enters the body it turns it into estrogens. Increased level of estrogen in the system has serious side effects that have to be carefully monitored.

Estrogen has not to be seen as something bad. It has very specific functions in the body like increasing the bone mass, improve libido and greatly add muscle mass if combined with testosterone steroid, for example. Estrogen is a natural steroid, which directly participate in the muscle building process. Along with this, it makes the body to use glucose in a better way, which definitely reduce the recovery period. Being  back in the gym as soon as possible and full of energy and with no soreness is the thing that every bodybuilder want. And estrogen has good influence on all this.

But it have to be kept in normal limits. When it goes too high, serious side effects may occur as gynecomastia, weakness of immunity, and cholesterol issues. There are at least five types of antiestrogens recommended for use during post cycle therapy to reduce estrogenic activity in the body.

Antiestrogens drugs:

Arimidex(Anastrozole)

Clomid (Clomiphene Citrate)

Femara(Letrozole)

HCG (Human Chorionic Gonadotropin)

Nolvadex

We can not say about these drugs that are very expensive as they were few years ago when 1 mg pill of brand name of Arimidex was sold with ten dollars. Nowadays the steroid market is much diversified, and you can find the same product at a very good price. Especially if you are not looking for brand names, and are ready to buy those produced by underground labs.

What are the most aromatizing steroids

All steroids aromatase. This is the most important detail every person looking to get bigger have to bear in mind. But the way they do it differ in some degree. That’s why we can talk about most and less aromatizing steroids, but not about the concept of non aromatization at all. Also, there are individual characteristics as high number of aromatase enzymes in the body, which can turn a low aromatizing steroid into one very estrogenic.

Over the years of experience it was observed that several anabolic steroids induce a greater estrogenic activity when area administered.

Top 4 most aromatizing steroids:

-Dianabol;

-Anadrol;

-Testostosterone;

-Deca

Both forms of Dbol, liquid and pills, have a high estrogenic activity. The same thing can be said about esters of testosterone. It is tremendously to run a proper post cycle therapy with recommended antiestrogens when stacking two or more steroids from the above list. Do it because these steroids are in most cases associated with gyno development.

Water retention is in another unwanted side effects caused by aromatization. Water retention means that you body hold more water, making you look swallowed especially on face aria. Also, it cause in man fat deposition along the waist. The lower is estrogenic activity in the body while running a cycle, the less water your body retain. In other words, in the end of steroid cycle you will have more lean muscle mass gains, instead of such unwanted fat. Antiestrogens are at great importance in this case, so make sure you have them included in your steroid cycle plan.

Considerations

Aromatization is the process during which the surplus of testosterone is turned into estrogens. It comes as a result of body tendency to keep an overall balance. Estrogen in normal limits is very beneficial for body since it improves libido, increase bone mass and makes the muscles get bigger especially if mixed with a synthetic steroid like testosterone. But when high amounts of testosterone enters the body, the estrogen level goes high too, causing serious health problems like gynecomastia, weak immunity and cholesterol changes.

Most of bodybuilders want a non-aromatizing steroid at all, this being unreal. Since all steroids more or less are aromatizing. So, the best would be mention low and high aromatizing steroids. The number of aromatase enzymes in the body have a great importance, the higher is their number the more testosterone into converted into estrogen. Thereby, even a low aromatizing steroid can be quite powerful for such a person.

Prostate cancer and steroids

The human organism is, at birth at least, a well rounded, timed and compact machine, that can function in all conditions on the planet, more or less. The evolution of man has seen to it that the body and organism of man are changed only minimally. We are on top of the food chain in this world, and have no natural enemies, in order to restore balance in the universe Mother Nature has made us susceptible to various types of sicknesses, diseases, viruses etc.

Of course, being as intelligent as we are, the human race has invented medicines for the vast majority of health issues that have been troubling us for many years. That is to say that humans are still yet to find a cure for some of the most dangerous and stubborn sicknesses that have ever existed-HIV, AIDS, cancer etc.

Take cancer, for example: it’s been around for years but no one seems to have been able to find the solution for it. When it strikes, it strikes hard and leaves very little chance of recovery. It can appear almost anywhere in the body, but in the case of cancer location makes no difference-whether it’s:
• Lung
• Stomach
• Tongue
• Throat or
• Prostate- it rarely goes away.

The paradox
Persistent as they are, humans have been trying to find the answer but all of the efforts seem to have been in vain. If you look at prostate cancer-the common medical practice states that, depending on the current state and progression level of the cancer, a prostate intervention is what is needed (in the majority of cases).

However, in recent times it was noticed that androgen therapy has, contrary to popular belief and practice, resulted in an improvement with androgen deficiency symptoms and concomitant prostate disease. What’s more, it is unexplainable how or why the current prostate cancer treatments, such as early discovery and prostate cancer screening, have come to become the common ways of treating prostate cancer, especially since there is no evidence or indication whatsoever in medical literature that support the claim that androgens worsen or even cause prostate disease in the first place.

The eye-opener
In recent experiments and analysis, it was demonstrated that PSA testing (Prostate Specific Antigen) and DRE screening (Digital Rectal Exam) do not significantly reduce prostate cancer rate of death. Furthermore, if PSA and DRE screening results lead to a false finding, which causes patients to receive a surgical procedure that is quite significant-the consequence is a sizeable screening burden. Also, it is noticeable that patients with prostate cancer are receiving a considerable amount of over-treatment simply because prostate cancer screening and also many treatments that follow are so widespread and urgent.

Another type of therapy for prostate cancer that is being used against reason is the androgen ablation therapy-it’s very expensive. The reasons why it’s not very cost effective are primarily the lack of beneficial and usable results, the contrasting effects that cannot be avoided and must be endured, and the considerable costs of the therapy itself.

The solution
Since most anabolic steroids are known to increase testosterone levels in the body, testosterone therapy can potentially be used to improve many signs and recognized symptoms of prostate cancer, and ones that have to do with the deficiency of testosterone in particular. Testosterone therapy can be linked to many positive effects for prostate cancer treatment, unlike androgen deprivation therapy (ADT), for example, which is known to cause the exact opposite effect than that of the testosterone therapy.

The summary
The original and commonly used prostate cancer treatment practices have never been based on appropriate and sufficient data. The true power of evidence based medicine is depicted in the recent realization that the common practices are not only inadequate and ineffective, but also that new and until now untested methods of treatment, such as increasing patients’ testosterone levels, are the way to go in the battle with prostate cancer.

Testosterone Replacement Therapy

“Testosterone Replacement Therapy” these words have become more common with every passing year but many still have no clue as to what testosterone replacement therapy really is. You’ve seen the commercials for “Low-T” and if you ask most men they sound great but many still have no clue “Low-T” is nothing more than testosterone replacement therapy and this therapy unknown to even more is nothing more than a legal prescription for anabolic steroids. That’s right, anabolic steroids; testosterone replacement therapy refers to a treatment in-which low levels of the naturally occurring hormone testosterone are brought back into an adequate range. To perform this function the anabolic steroid testosterone, a synthetic version of the hormone our body produces must be administered.

If you possess any understanding of the performance enhancing world, on its surface the idea of testosterone replacement therapy may bring you a sigh of relief but more than likely it probably irritates you at the same time. After all, for years we’ve been told anabolic steroids are brewed in the bowels of hell but if you receive testosterone replacement therapy this same hormone from which all anabolic steroids are derived from, now it’s a welcomed beacon of hope. Yes, you are correct; episodes of the Twilight Zone make far more sense than this confusing conundrum.

Let’s from this point on be clear and precise; these advertisements for “Low-T” treatment and things of this nature are nothing more than advertisements and promotions for anabolic steroids. When you inquire about testosterone replacement therapy understand you’re inquiring regarding anabolic steroids; let’s call a spade a spade. We are still a long way off from anabolic steroids being generally accepted by the whole of society but it is within testosterone replacement therapy this acceptance holds its most promising form. ,/p>

If you are still unfamiliar with testosterone replacement therapy the idea is very simple. Testosterone replacement therapy is simply providing the body the testosterone it needs in-which it no longer produces naturally. Further, this same therapy is many times provided to increase testosterone levels in men who may not have a decline per say but who naturally do not make enough testosterone. This is where things find themselves a little murky; there isn’t a set level of testosterone production that is considered “Natural,” for the amounts produced vary from person to person. Even so, the idea is sound and very well received by most all men who receive it.

There are those who desire to see testosterone replacement therapy thrown into the trash pile of life; why? We don’t have a good specific answer for you because they have yet to give one themselves. Men who receive testosterone replacement therapy enjoy a higher quality of life, they feel better, and they become sick far less often and are generally happier individuals. Why on earth anyone would ever want to legislate testosterone replacement therapy into the ground is beyond reason and comprehension.

Young men dying from heart disease linked to steroid use

Men in their late 20s and early 30s who abuse steroids are dying from serious heart disease, a study has revealed.

But researchers say increasing numbers of steroid users are oblivious to the severe health risks linked to performance-enhancing drugs, including cardiovascular disease, reproductive failure, liver damage and high levels of aggression.

Nearly all men showed obvious signs of chronic steroid abuse, including overdeveloped muscles and shrunken, scarred testicles

The irony is that steroid users are often health-oriented, but they're using a drug that is damaging their bodies to the point it could kill.

The study examined 24 deaths in men aged 22 to 48 over the past 17 years where steroids were found in the system of the person who had died. Nearly all men - most employed as personal trainers, body builders and security guards - showed obvious signs of chronic steroid abuse, including overdeveloped muscles and shrunken, scarred testicles.

These men are doing major damage to their hearts and are substantially increasing their risk of death. For a very young group in their early 30s, their cardiac health looks like what you would expect of someone twice their age. More than half the men analysed had shrunken testicles, which is likely to impair the reproductive system.

While steroids were not the direct cause of death, 62.5 per cent of men died from taking toxic amounts of steroids together with other illicit drugs - including cocaine and methamphetamine - either alone or in combination with heart disease. More than half had serious heart disease, including thickened arteries and damaged heart muscles.

About a quarter of deaths were caused by suicide or homicide, which links long-term steroid use with an increased risk of aggressive and violent behaviour.

Steroids Ineffective and Possibly Harmful in Pediatric Liver Disease

Treating infants with high doses of steroids fails to improve medical outcomes in the end-stage pediatric liver disease biliary atresia and leads to earlier onset of serious adverse events, says a new study.

Researchers say the clinical trial involving 14 sites provides new evidence on a growing controversy in the medical community - whether treating infants with steroids to augment surgery improves outcomes.

The results from this clinical trial differ from previous reports of a benefit from steroid therapy on bile drainage or survival in biliary atresia. Although it cannot be excluded some small potential benefit from steroid treatment, observed no statistical differences in two-year survival between patients receiving steroid treatment after surgery and those receiving placebo. Children receiving steroids during the study also developed serious adverse events more quickly, raising a potential increase in risks associated with steroid therapy.

Biliary atresia is the leading cause of pediatric liver transplantation in the world. The disease accounts for about 50 percent of transplants in children and 10 percent of transplants at any age. It results from inflammation and rapid accumulation of connective tissues that obstruct and restrict bile ducts from draining. The condition then manifests as cholestatic jaundice in the first few weeks after birth.

At diagnosis, the primary treatment is the hepatoportoenterostomy (HPE, the Kasai procedure) - a surgical procedure that removes the diseased bile ducts and gallbladder and connects an intestinal loop directly to the liver to restore bile drainage. Study authors point out that some clinicians suggest steroid treatment after surgery may help prevent additional fibrosis and improve bile drainage. The current study - called START (Steroids in Biliary Atresia Randomized Trial) - was designed to provide rigorous medical data to help answer that question.

The study involved 140 infants with a median age of 2.3 months. The initial study was conducted between September 2005 and February 2011, with follow up ending in January 2013.

Researchers report that in 70 children treated with steroids, bile drainage was not significantly different six months post-surgery compared to 70 children who received placebo after surgery. Of the 70 who received steroids, 41 of 70 patients (58.6 percent) had improved bile drainage. Of 70 patients who did not receive steroids, 34 of 70 (48.6 percent) had improved bile drainage.

When researchers compared survival rates between the steroid/non-steroid groups at age 24 months, 58.7 percent of children in the steroid group survived compared to 59.4 percent in the placebo group.

The percent of children who experienced serious safety events was relatively the same between the steroid group (81.4 percent) and non-steroid group (80 percent), but children who received steroids had an earlier time to onset for those events. Serious safety events occurred with 30 days post-surgery in 37.2 percent of children who received steroid treatment, versus 19 percent in the placebo group.

Potential serious safety events the authors pointed to included complications such as immunosuppression, associated risk of infection, poor wound healing, hyperglycemia, gastrointestinal bleeding, poor growth, and inadequate response to routine immunizations.

Steroids and Cancer Treatments

When you hear the word steroid you may think of "roid rage" and muscle-bound gym rats with shrunken testicles. But if your doctor prescribed steroids as part of your treatment for cancer or another serious illness, don't worry. It's not "that" kind of steroid.
Your doctor is actually talking about cortisol, a form of steroid that your body produces naturally. It's different from anabolic steroids, which are the illegal muscle-building kind.

How Steroids Help

Although the cortisol-type steroids prescribed for cancer treatment are different from anabolic steroids, you still need to take them under the close supervision of your doctor or medical specialist.
You'll probably get a manmade version of the natural steroid cortisol, such as:

• cortisone
• hydrocortisone
• prednisone
• methylprednisolone
• dexamethasone

These can help with your treatment in a variety of ways:

• reduce nausea associated with chemotherapy and radiation
• kill cancer cells and shrink tumors as part of chemotherapy
• decrease swelling
• reduce allergic reactions (before transfusions, for example)
• lessen headaches caused by brain tumors

Sometimes, your doctor will recommend steroid treatments just to help you sleep, eat, and feel better.
Doctors can prescribe steroids for cancer treatment several ways:

• by injection
• through an intravenous (IV) drip
• in liquid or pill form
• as a cream

Steroids used in medical treatments can have some side effects, although they're not as extreme as the side effects from anabolic steroids. Talk to your doctor and ask questions if you're worried.
You may not have any side effects. But if you do, don't worry — they'll only last as long as you're taking the steroids. When you stop your treatment, things will return to normal.
Some of the more common side effects of steroid treatments include:

• increased appetite
• weight gain, often in unfamiliar places, like your cheeks or the back of your neck
• mood swings
• stomach upset or ulcers
• osteoporosis (weaker bones)
• vision problems
• higher blood pressure
• increased blood sugar. Sometimes, people develop diabetes temporarily. If you already have diabetes, you'll need to monitor your blood sugar levels more closely.
• for girls, irregular menstruation (missed or late periods)

Less common side effects include bruising more easily, difficulty fighting infections, acne flare-ups, and increased facial hair.
If you develop several of these symptoms, you have a condition called Cushing syndrome. Sometimes it gets better if you make changes in the way you take the steroids. If you're having problems with these side effects, talk to your doctor.
Remember, you may not have any side effects. If you do, you'll probably find that they're overshadowed by the benefits of the treatment. But check with your doctor about ways to make them easier to live with.

What Conditions Are Treated With Steroids and Their Benefits?

Steroids are used to treat a variety of conditions in which the body's defense system malfunctions and causes tissue damage. Steroids are used as the main treatment for certain inflammatory conditions, such as systemic vasculitis (inflammation of blood vessels) and myositis (inflammation of muscle). They may also be used selectively to treat inflammatory conditions such as rheumatoid arthritis, lupus, Sjögren's syndrome, or gout.

What Are the Benefits of Steroids?

When inflammation threatens to damage critical body organs, steroids can be organ saving and, in many instances, life-saving. For example, they may help prevent the progression of kidney inflammation, which can lead to kidney failure in people who have lupus or vasculitis. For these people, steroid therapy may eliminate the need for kidney dialysis or transplant.

Low doses of steroids may provide significant relief from pain and stiffness for people with conditions including rheumatoid arthritis. Temporary use of higher doses of steroids may help a person recover from a severe flare-up of arthritis.

What Conditions Are Treated With Steroid Injections?

Steroids often are injected directly into joints to treat conditions such as rheumatoid arthritis, gout, or other inflammatory diseases. They also can be injected into an inflamed bursa or around tendons near most joints in the body.

Some people report relief from osteoarthritis when steroids are injected directly into swollen or painful joints.

What Are the Expected Benefits of Steroid Injections?

Steroid injections into a specific area are generally well tolerated and are less likely than other forms of steroid drugs to produce serious side effects. Also, the injections may help avoid the need for oral steroids or increased doses of oral steroids, which could have greater side effects.

What Role Do Steroid Injections Play in an Overall Treatment Program?

Steroid injections can be added to a treatment program that may already include anti-inflammatory pain medications (NSAIDs), physical therapy, occupational therapy, or supportive devices such as canes and braces. Whether one or more of these treatment methods are used depends on the nature of the problem.

For example, in an otherwise healthy person, tendinitis may be adequately treated with only a steroid injection into the inflamed area. However, in a person with rheumatoid arthritis, injections are generally a small part of a multifaceted treatment approach.

When Should Steroid Injections Not Be Used?

Steroids should not be injected when there is infection in the area to be targeted or even elsewhere in the body because they could inhibit the natural infection-fighting immune response. Also, if a joint is already severely destroyed, injections are not likely to provide any benefit.

If someone has a potential bleeding problem or is taking anticoagulants (often referred to as blood thinners), steroid injections may cause bleeding at the site. For these people, injections are given with caution.

Frequent steroid injections, more often than every three or four months, are not recommended because of an increased risk of weakening tissues in the treated area.

Topical Steroids for Eczema Treatment

Topical steroids are used in addition to emollients for treating eczema. Topical steroids reduce skin inflammation. A short course will usually clear a flare-up of eczema. Side-effects are unlikely to occur with short courses.
What are topical steroids and how do they work?

Topical steroids are creams, ointments and lotions which contain steroid medicines. Topical steroids work by reducing inflammation in the skin. They are used for various skin conditions including eczema. (Steroid medicines that reduce inflammation are sometimes called corticosteroids. They are very different to the anabolic steroids which are used by some bodybuilders and athletes.)


What types of topical steroids are there?

There are many types and brands of topical steroid. However, they are generally grouped into four categories depending on their strength - mild, moderately potent, potent and very potent. There are various brands and types in each category. For example, hydrocortisone cream 1% is a commonly used steroid cream and is classed as a mild topical steroid. The greater the strength (potency), the more effect it has on reducing inflammation but the greater the risk of side-effects with continued use.

Creams are usually best to treat moist or weeping areas of skin. Ointments are usually best to treat areas of skin which are dry or thickened. Lotions may be useful to treat hairy areas such as the scalp.
When and how are topical steroids used?

As a rule, a course of topical steroid is used when one or more patches of eczema flare up. The aim of treatment is to clear the flare-up and then to stop the steroid treatment.

It is common practice to use the lowest strength topical steroid which clears the flare-up. So, for example, hydrocortisone 1% is often used, especially when treating children. This often works well. If there is no improvement after 3-7 days, a stronger topical steroid is usually then prescribed. For severe flare-ups a stronger topical steroid may be prescribed from the outset.

Sometimes two or more preparations of different strengths are used at the same time. For example, a mild steroid for the face and a moderately strong steroid for patches of eczema on the thicker skin of the arms or legs. A very strong topical steroid is often needed for eczema on the palms and soles of the feet of adults because these areas have thick skin.

You should use topical steroids until the flare-up has completely gone and then stop it. In many cases, a course of treatment for 7-14 days is enough to clear a flare-up of eczema. In some cases, a longer course is needed.

Many people with eczema require a course of topical steroids every now and then to clear a flare-up. The frequency of flare-ups and the number of times a course of topical steroids is needed varies greatly from person to person.

After you finish a course of topical steroid, continue to use emollients every day to help prevent a further flare-up. See separate leaflet called 'Emollients  for Eczema' for more details.
Short bursts of high-strength steroid as an alternative

For adults, a short course of a strong topical steroid may be an option to treat a mild-to-moderate flare-up of eczema. A strong topical steroid often works quicker than a mild one. Short-duration treatment to prevent flare-ups.

Some people have frequent flare-ups of eczema. For example, a flare-up may subside well with topical steroid therapy. But then, within a few weeks, a flare-up returns. In this situation, one option that might help is to apply steroid cream on the usual sites of flare-ups for two days every week. This is often called weekend therapy. This aims to prevent a flare-up from occurring. In the long run, it can mean that the total amount of topical steroid used is less than if each flare-up were treated as and when it occurred. You may wish to discuss this option with your doctor.

Drugs that can Harm the Immune System

The flu is rarely deadly. It's flu that becomes pneumonia that kills. Prescription and over-the-counter drugs should be seriously considered on the list of things that could potentially make people more susceptible to having a flu that morphs into a deadly pneumonia.

Steroids
All steroid drugs, from corticosteroids to anabolic steroids, suppress the immune system that defends against bacterial and viral infections such as pneumonia.

Chronic stress creates greater susceptibility to infection because it raises cortisol levels. Cortisol is a steroid hormone released by the adrenal glands that has many side effects when it’s chronically high. One side effect is that it reduces inflammation. At first glance that sounds good, but at the same time it suppresses the immune system. Chronically high cortisol also disrupts blood sugar balance, often leading to high insulin, obesity and sometimes, diabetes.

The most common route of steroid drug use, particularly in children, is through asthma inhalers.
Most asthma inhalers contain some form of synthetic steroid. These steroids help reduce the airway inflammation associated with asthma, but at the same time can reduce the ability of the lungs to fight bacterial and viral infections.

Steroid drug abuse among high school and college athletes is common. The National Institute on Drug Abuse estimates that 1 – 6% of high school athletes use steroid drugs to enhance their performance. This amounts to potentially hundreds of thousands of teens with suppressed immune systems who are more susceptible to viral and bacterial infection.

Steroid drugs such as prednisone are widely prescribed for people with painful inflammatory diseases such as arthritis, and for autoimmune diseases such as multiple sclerosis and lupus. They are also prescribed for those with organ transplants to suppress a rejection response by the immune system.

Even the regular use of cortisone creams for arthritis can raise cortisol levels enough to suppress the immune system.

 PPI Heartburn Drugs that Suppress Stomach Acid
Proton pump inhibitors or PPIs such as Nexium, Prevacid and Prilosec powerfully block the secretion of stomach acid. This has the effect of reducing heartburn and nausea, but it also blocks one of the body’s main defenses against bacteria and viruses. According to a 2004 study published in the Journal of the American Medical Association (JAMA), 70% of the hospitalized patients in the study received a PPI or other stomach acid-suppressing drug within hours of being admitted. The study showed that patients who were given PPIs had a 30% higher risk of developing pneumonia.

Statin Drugs to Lower Cholesterol
A medical group in Switzerland found that organ transplant patients who were taking statin drugs (e.g. Lipitor, Mevacor, Pravachol) did better than those who weren’t taking the drugs. Laboratory studies showed that statins did indeed suppress parts of the immune system, and the authors concluded, “This unexpected effect provides a scientific rationale for using statins as immunosuppressors, not only in organ transplantation but in numerous other pathologies as well.”

SSRI Antidepressants
The selective serotonin reuptake inhibitor antidepressant drugs (SSRIs) such as Prozac, Zoloft and Paxil increase serotonin levels and in so doing also give the immune system a boost. This boost can be the good news or the bad news. According to researchers at Georgetown University Medical Center, this boost can push the immune system into autoimmune disease, where the body starts attacking itself. These types of immune system over-reactions are also implicated in the “cytokine storms” that can create deadly inflammation in the lungs.

Opioid Drugs
Both short term and long term use of the pain killing opioid drugs such as hydrocodone, oxycodone, fentanyl, codeine and morphine block the immune system’s ability to attack viral and bacterial invaders. Some pain killing drugs such as Tramdol combine an opioid with acetaminophen (e.g. Tylenol), further compromising the immune system with acetaminophen’s toxic effects on liver function.

Anti-Inflammatory Medications in Cystic Fibrosis Treatment

Eventually, most people with any type of chronic lung disease will find themselves taking an anti-inflammatory medication at some point in their treatment. Anti-inflammatory medications improve breathing by reducing swelling of the air passages. Some anti-inflammatory medications are taken for short periods to help speed recovery when a patient has a respiratory infection or other problem causing a flare-up of breathing difficulty. Some anti-inflammatory medications are taken long-term to help prevent swollen air passages and improve lung function.

Corticosteroids vs. Anabolic Steroids

Corticosteroids: Medications that imitate the effects of a hormone produced in the adrenal gland called "cortisol," which has many functions in the body including fighting stress and reducing inflammation.

Anabolic steroids: Synthetic versions of male sex hormones that increase male characteristics. Athletes sometimes use them illegally to increase muscle mass and strength. There are legitimate medical conditions for which anabolic steroids may be prescribed, but lung disease is not one of them.

Oral steroids, such as prednisone, prednisolone or methylprednisone, are sometimes prescribed to people with cystic fibrosis (CF) for short-term treatment. They are not recommended for long-term therapy because of the potential for serious side effects including:

    Growth retardation in children
    Diabetes
    Cataracts
    Osteoporosis
    Decreased ability to fight lung infections, such as the potentially deadly Pseudomonas aeruginosa

Inhaled Steroids

Inhaled steroids, such as Qvar (beclomethasone), Pulmicort (budesonide) and Flovent (flucticasone), are delivered directly to the lungs and have less side effects than oral steroids. Studies have not shown any particular benefit of long-term inhaled steroids for people with cystic fibrosis, though, so the Cystic Fibrosis Foundation advises against the routine use of inhaled steroids in people with CF unless they also have asthma.

Steroids and HIV Infection

The connection between injection drug use and HIV infection is well known. Sharing injection equipment such as needles and syringes presents a real risk of transmitting HIV as well as Hepatitis C. However, the injection of steroids is often overlooked as a risk behaviour.

Unlike mood-altering drugs, steroids are not perceived as having any health risks and, therefore, the user does not think he/she is in any danger.
Who Uses Steroids?

The majority of users are high school students. Other users may include strip dancers, wrestlers, weight lifters, military personnel and prisoners. The use of anabolic steroids for cosmetic purposes far exceeds their use by athletes for competition. The preferred method of use is by injection rather than by mouth.

Steroid use is a short cut to self-esteem. It needs little investment in energy and its reinforcing results are almost immediate. In a society that places so much value on body image, steroids are seen as a quick and easy response to that pressure.
What Are The Risks?

Most of the negative effects of steroids are due to overuse or misuse. The side effects may include: liver damage, sexual difficulties, aggressive behaviour, depression, acne, muscle spasms and interference with normal growth. Some of the effects are reversible after discontinuing the steroid use. However, the very real health risks are from:

    sharing needles, syringes and vials
    improper injection site
    failure to clean injection site
    failure to ensure the needle is not in a vein or artery

Steroid users must be given the opportunity to decide for themselves the negative aspects of steroid use. Until they are ready to quit, it is essential to help our young people stay alive. Any discussion of HIV/AIDS should ensure that use of steroids is included as a risk behaviour. In addition, information on the proper use of injection equipment must be readily available.

When Are Steroids Indicated In Epstein-Barr Virus Infections?

Infectious mononucleosis, caused by Epstein-Barr virus, is generally characterized by a triad of pharyngitis, fatigue, and cervical lymphadenopathy. Fever and splenomegaly are also common in presentation. These are symptoms primarily manifested by the host response rather than direct viral infection. The severity and duration of symptoms are variable and most commonly resolve by 2 to 3 months postinfection. However, some such as lymphadenopathy and fatigue may persist. Treatment is generally supportive and con- sists of rest (although strict bed rest is not necessary), over-the-counter symptomatic relief for fever and throat pain, and avoidance of contact sports until the patient is asymptomatic and, if splenomegaly is present, you are no longer able to palpate the spleen.

The use of steroids for treatment of infectious mononucleosis has long been controversial.  The lack of clear evidence of benefit has led to universal recommendations indicating that steroids have no role in the routine use of treatment of infectious mononucleosis. However, despite this, steroids continue to be used somewhat liberally in uncomplicated cases, perhaps to hasten return to school and normal activities because of persistent symptoms, patient demand, or the physician’s personal experience, clinical judgment, or training. Steroids are not without adverse effects. Rare case reports have linked the use of steroids for routine mononucleosis with myocarditis, mostly mild and asymptomatic, but causing supraventricular tachycardia in one case,  and neurologic complications including meningoencephalitis, seizures, and brachial plexus palsy.

Most patients with an acute EBV infection have a self-limited course and recover without sequelae. Rarely, however, severe complications can occur in both healthy and immonocompromised patients. It is during these times that the use of steroids may, indeed, be warranted. Airway obstruction or impending airway obstruction is due to tonsillar hypertrophy and occurs in approximately 3.5% of patients but has been reported to occur in as many as 25% of cases.9 Massive splenomegaly and splenic rupture are the other most commonly feared complications. Although mild splenomegaly is quite a common finding in acute mononucleosis, found in approximately 50% of patients, serious splenic complications are very rare, occurring in less than 1%. Splenic rupture usually is found to occur during the second and third weeks of illness, at the peak of splenomegaly. Neurologic complications occur in less than 1% of patients. Two of the most common neurologic complications are encephalitis and cranial nerve palsies. Other neurologic complications that have been reported are aseptic meningitis, acute disseminated encephalomyelitis, transverse myelitis, Guillain-Barré syndrome, optic neuritis, and Alice-in-Wonderland syndrome (a perceived distortion of object size).10  Other life-threatening complications reported include myocarditis, fulminant hepatitis, and liver failure, and hematologic manifestations such as hemolytic anemia, idiopathic thrombocytopenic purpura, and hemophagocytic lymphohistiocytosis. These, and other life-threatening complications, are all indications for use of steroid therapy. Steroids have been used anecdotally and in small case series for these indications, but no rigorous studies have been performed to confirm the benefit of steroid use in these situations. Nevertheless, it is expert opinion that steroids may be useful for these potentially life-threatening complications of EBV infection.

Steroids to Treat Arthritis

What Conditions Are Treated With Steroid Injections?

Steroids often are injected directly into joints to treat conditions such as rheumatoid arthritis, gout, or other inflammatory diseases. They also can be injected into an inflamed bursa or around tendons near most joints in the body.

Some people report relief from osteoarthritis when steroids are injected directly into swollen or painful joints.

What Are the Expected Benefits of Steroid Injections?

Steroid injections into a specific area are generally well tolerated and are less likely than other forms of steroid drugs to produce serious side effects. Also, the injections may help avoid the need for oral steroids or increased doses of oral steroids, which could have greater side effects.

What Role Do Steroid Injections Play in an Overall Treatment Program?

Steroid injections can be added to a treatment program that may already include anti-inflammatory pain medications (NSAIDs), physical therapy, occupational therapy, or supportive devices such as canes and braces. Whether one or more of these treatment methods are used depends on the nature of the problem.

For example, in an otherwise healthy person, tendinitis may be adequately treated with only a steroid injection into the inflamed area. However, in a person with rheumatoid arthritis, injections are generally a small part of a multifaceted treatment approach.

When Should Steroid Injections Not Be Used?

Steroids should not be injected when there is infection in the area to be targeted or even elsewhere in the body because they could inhibit the natural infection-fighting immune response. Also, if a joint is already severely destroyed, injections are not likely to provide any benefit.

If someone has a potential bleeding problem or is taking anticoagulants (often referred to as blood thinners), steroid injections may cause bleeding at the site. For these people, injections are given with caution.

Frequent steroid injections, more often than every three or four months, are not recommended because of an increased risk of weakening tissues in the treated area.

Pros and Cons of Topical Steroids for Viral Conjunctivitis

Many physicians have found topical steroids to be helpful for patients with debilitating conjunctivitis. By reducing inflammation, steroids can bring dramatic improvement in patient comfort. However, others caution that steroids may delay resolution of the disease, prolonging the contagious course of the virus. In fact, studies in rabbit models have shown that topical steroids may prolong ocular shedding of adenovirus by several weeks.

Until recently, no well-designed human study has assessed the risks and benefits of topical steroids in the treatment of viral conjunctivitis. In a study by Wilkins and colleagues,3 111 patients with presumed viral conjunctivitis were randomly assigned to receive either preservative-free dexamethasone 0.1% or hydroxypropyl methylcellulose (the vehicle used by the Moorfields pharmacy for compounding topical dexam- ethasone) four times daily for 1 week. Statistically significantly more patients in the dexamethasone group (39 of 45) felt the drops to be helpful than in the vehicle group (30 of 43). No adverse events were seen in either group.

The decision to use steroids for the treatment of viral conjunctivitis is a personal one. Research has shown that, when used appropriately (ie, in cases where bacterial or herpetic infection has been ruled out and when used in short pulses), topical steroids can be beneficial to patients by ameliorating the symptoms for which they initially presented. Steroid use may somewhat prolong the length of the contagious period; however, many patients will gladly accept this so that they may begin to feel ocular relief.

Topical steroid drops should be used with great caution, as herpetic viral infection of the ocular surface is a common mimicker of adenoviral conjunctivitis, and unopposed steroid drops can promote viral replication and corneal scarring. Additionally, as noted above, multiple studies have demonstrated that topical steroids prolong the viral shedding period.2 The key to managing adenoviral conjunctivitis is to limit its spread. Patients with viral conjunctivitis who are treated with topical steroid drops may return to work or school while they are still in the contagious phase of the infection, and therefore have the potential to further increase the disease burden on the health care system.

Because the symptoms of adenoviral conjunctivitis may be severe, investigators have explored other treatment options for patients with symptomatic disease including a topical combination of dexamethasone 0.1% and povidoneiodine 0.4%.4 This novel formulation was compared with cidofovir 0.5%, a combination tobramycin-dexamethasone ophthalmic suspension (Tobradex; Alcon Laboratories, Inc., Fort Worth, Texas), and balanced salt solution in rabbit eyes. The combination topical dexamethasone 0.1% and povidoneiodine 0.4% was equally effective as cidofovir 0.5% in reducing viral titers and was the most efficacious in reducing clinical symptoms of adenovirus infection in rabbit eyes.

A dexamethasone/povidone-iodine combination drop is not yet commercially available, but other options are. Gordon et al demonstrated that topical ketorolac or diclofenac did not increase the viral shedding period and may be a safer alternative t topical steroids.5 More recently, during an epidemic of viral conjunctivitis in a military garrison in Karachi, Pakistan, 200 patients were randomly assigned to topical decongestant/antihistamine combination drops or to eye washing and cool compresses.6 Acute illness symptoms of eye watering, itching, burning, pain, and photophobia lasted a mean 4.91 days in the decongestant/ antihistamine drop and 7.86 days in the cool compresses group. 

Steroids and Viral Infections in Kids

Researchers have discovered the wheezing and steroids don't mix when it comes to children. Two studies show that steroids do not change the course of viral infections in children.

The researchers tested 700 children aged 10 months to 5 years old. The study showed that children stayed in hospital the same amount of time regardless if they had steroids or not from viral infections that caused wheezing.
At this time doctors treat wheezing from infections the same as they do in asthmatic children.
The study also showed that steroids didn't change the symptoms over the following seven days.

A second study compared the use of steroids and a placebo in 129 children aged 1 to 6. The children were given one of the two at the first sign of nasal congestion, sore throat or any other symptom that might show an upper respiratory tract infection was coming on. The children received the treatment for up to 10 days twice daily. The drug seemed to help.
Eighteen percent of the children in the placebo group had to have additional steroid drugs. The children that had used steroids needing the additional medication was at eight percent.
The children using steroids grew less though than the ones in the placebo group.

Steroids to Treat Arthritis

Steroids  are synthetic drugs that closely resemble cortisol, a hormone that your body produces naturally. Steroids work by decreasing inflammation and reducing the activity of the immune system. They are used to treat a variety of inflammatory diseases and conditions.

Corticosteroids are different from anabolic steroids, which some athletes use to build bigger muscles. Examples of corticosteroid medications include triamcinolone, cortisone, prednisone, and methylprednisolone.
How Are Steroids Given?

Steroids can be given topically (cream or ointment), by mouth (orally), or by injection. When injected, they can be given into a vein or muscle, directly into a joint or bursa (lubricating sac between certain tendons and the bones beneath them) or around tendons and other soft tissue areas.
How Do Steroids Work?

Steroids decrease inflammation and reduce the activity of the immune system. Inflammation is a process by which the body's white blood cells and chemicals protect the body against infection and foreign organisms such as bacteria and viruses.

In certain diseases, however, the body's defense system (immune system) doesn't function properly and is overactive. This may cause inflammation to work against the body's own tissues and cause tissue damage. Inflammation is characterized by redness, warmth, swelling and pain.

Steroids reduce the production of inflammatory chemicals in order to minimize tissue damage. Steroids also reduce the activity of the immune system by affecting the function of white blood cells.
What Conditions Are Treated With Steroids?

Steroids are used to treat a variety of conditions in which the body's defense system malfunctions and causes tissue damage. Steroids are used as the main treatment for certain inflammatory conditions, such as systemic vasculitis (inflammation of blood vessels) and myositis (inflammation of muscle). They may also be used selectively to treat inflammatory conditions such as rheumatoid arthritis, lupus, Sjögren's syndrome, or gout.
What Are the Benefits of Steroids?

When inflammation threatens to damage critical body organs, steroids can be organ saving and, in many instances, life-saving. For example, they may help prevent the progression of kidney inflammation, which can lead to kidney failure in people who have lupus or vasculitis. For these people, steroid therapy may eliminate the need for kidney dialysis or transplant.

Low doses of steroids may provide significant relief from pain and stiffness for people with conditions including rheumatoid arthritis. Temporary use of higher doses of steroids may help a person recover from a severe flare-up of arthritis.

How Do I Know If Steroid Treatment Is Right for Me?

The decision to prescribe steroids is always made on an individual basis. Your doctor will consider your age, your overall health, and other drugs you are taking. Your doctor also will make sure you understand the potential benefits and risks of steroids before you start taking them.