Steroids

The term ‘steroid’ is synonymous with the idea of making something bigger. This idea stems from the misuse of synthetic anabolic steroids, which have been made famous by athletes who have abused steroids to run faster, lift heavier, and grow to enormous, unnatural proportions. But steroids are neither unnatural nor alien to the human body, instead they are essential for it to function. Humans naturally produce a vast array of steroids responsible for an equally diverse spectrum of functions. Steroids are key to defining our sex, they are instrumental in triggering and guiding our maturity, and they are essential to maintaining our health. However, our knowledge and capability to artificially synthesize steroids in the laboratory has unlocked yet more potential for these tiny compounds. Many synthetic steroids are used to bolster medicinal treatments, helping to alleviate symptoms and combat disease. Others are harnessed for more nefarious means, such as gaining an unfair advantage in sports competitions. By helping the body to build beyond its natural means, steroids can allow athletes to achieve the near-impossible, but this comes at the expense of their health.

All steroids are small chemical compounds derived from the lipid cholesterol. Cholesterol is important but has to be regulated by our cells, as too much can cause harm. Excess cholesterol, for example, causes the accumulation of plaque in our arteries, which can lead to angina and heart attacks. So while cholesterol is synthesized within our liver, this occurs less when we ingest more from our diet. Usually, around 80 per cent of our cholesterol is produced in the liver, providing ample building material for steroid derivatives. Steroids are produced in multiple locations in the body, including the gonads and the brain’s adrenal cortex. The adrenal cortex is divided into three regions, with each specializing as the production centres for a given class of steroids. The zona glomerulosa produces steroids known as mineralocorticoids, which regulate the amount of salt and water in the circulatory system. The zona fasciculata is primarily responsible for producing steroids known as glucocorticoids, which regulate the effects of the immune system. And the zona reticularis secretes androgenic steroids, otherwise known as sex hormones, which govern the development of traits associated with the two sexes. The male and female gonads also produce androgens, but the amount and type of androgen produced differs depending on the reproductive organ. Some androgens, such as testosterone, are anabolic steroids. This means that they signal for the production of lean muscle tissue. Mineralocorticoids and glucocorticoids, however, belong to a different group of steroids known as corticosteroids. These steroids maintain healthy bodily functions and are routinely used in prescription medicines.

As lipids, steroids are not soluble in water and therefore cannot be readily and stably carried to cells unaccompanied in the bloodstream. Instead, steroids are first synthesized in their precursor forms and, once the cell has received a signal for their release, they are converted into their active form and readily diffuse out of the cell. Then, once they are in the blood plasma, they attach to transport proteins that keep them stable as they are carried through the circulatory system to their target cell. Upon arriving at a cell with receptors on its surface that recognize the steroid, the compound can bind to it and trigger a cell response.

This response often includes a change in gene expression, which leads to the production of proteins that carry out new functions in the cell, changing its behavior. Therefore steroids are the mobile messengers of the body that despite being tiny compounds, can bring about massive changes.

Treating Cancer

Corticosteroids are involved in regulating many bodily functions in a healthy body. These include reducing inflammation, regulating mood, and controlling the balance of water and nutrients from food. When suffering from cancer, both the tumor itself and the treatment can negatively impact these processes, causing harmful side effects such as nausea and fatigue. Synthetic steroids can help restore balance and combat certain cancers such as lymphoma in a number of ways. They can be administered before treatment to help bolster a patient’s appetite. During treatment they can be used to combat an allergic reaction to another drug, reduce the side effects of chemotherapy, or to increase the effectiveness of chemotherapy. This latter aspect can be achieved in lymphoma patients by combining steroid treatment with chemotherapy treatment, as steroids can destroy lymphocytes. Sometimes the steroid treatment strategy can even be effective enough on its own to tackle specific types of cancers, meaning that chemotherapy isn’t required.

CHEMICAL STRUCTURE

Steroids are a class of lipids, which means they are insoluble in water but soluble in organic solvents. They all share a common main structure consisting of four fused rings of connected carbon atoms. These include three cyclohexane rings consisting of six carbon atoms, and one cyclopentane ring consisting of five carbon atoms, yielding seventeen in total. These 17 carbons atoms are numbered to help describe differences in steroid structures. Seemingly subtle changes at just a couple of the carbon positions can yield vastly different steroids. Cholesterol, from which all other steroids are derived, comes equipped with a hydrocarbon tail off its 17th carbon atom. This is removed when cholesterol is converted into either testosterone or estrogen. Despite these two steroids controlling vastly different cell behaviors, structurally they are very similar and differ at only four carbon positions.

All steroids, like testosterone shown here, have a chemical structure centered around four fused carbon rings

STEROID MISUSE

After the first synthesis of testosterone in 1935, it took less than two decades for anabolic steroids to be misused in professional sporting competition. In the years since they have been used in a myriad of sports and are still predominant in unregulated sports today, such as bodybuilding. Synthetic testosterone is the most infamous anabolic steroid for misuse, or ‘doping’. Our bodies synthesize testosterone naturally, with men producing more than women, which helps us build lean muscle. But synthetically increasing the amount of testosterone in our cells can trigger the production of more lean muscle than is achievable by our natural limits. While testosterone doping can increase lean muscle mass and improve strength, it can also cause severe side effects. In men these include shrunken testicles, breast development, and an increased risk of prostate cancer. In women these include growth of facial hair, severe acne, and period problems. Both genders are also at additional risk of heart attacks and strokes.

How Steroids Are Administered?

INJECTION

Injection steroids directly into muscle tissue allows doses to be lower than they would be for oral tablets, reducing the risk and severity of side effects.

ORAL TABLETS

For some disease oral administration of steroids is just as effective as injections. Tablets can also be self administered, making them preferable for conditions where steroids need to be taken for linger periods.

INHALERS

Topical steroids such as creams and ointment, which are administered onto the skin, offer similar benefits to inhalers for the external organs.

Steroids In The Body

RED :- Synthetic

GREEN :- Natural

Corticotropin

Produced by the pituitary gland in the brain, this glucocorticoid controls the secretion of cortisol from the brain’s adrenal cortex.

Betamethasone

This corticosteroid can be administered to the eye via drops to reduce inflammation, irritation and redness.

Testosterone

This androgen, or sex hormone, regulates male secondary sexual characteristics such as voice deepening and facial hair. It drives skeletal-muscular growth in both sexes.

Aldosterone

A type of steroid known as a mineralocorticoid, aldosterone regulates the amount of salt retained in the body, which determines blood pressure.

Fludrocortisone

Those with Addison’s disease, or people who’ve had their adrenal glands removed, lack natural aldosterone production. Fludrocortisone can be used to regulate blood salt levels in its place.

Androstenedione

Those with Addison’s disease, or people who’ve had their adrenal glands removed, lack natural aldosterone production. Fludrocortisone can be used to regulate blood salt levels in its place.

Estradiol

This androgen regulates female secondary sexual characteristics and governs fertility in both sexes. Estradiol regulates sperm production in males, and ovary development in females.

Budesonide

Like other corticosteroids, budesonide reduces inflammation. However this steroid does not readily escape into the bloodstream, making it an effective treatment for inflamed gut tissue.

Cortisol

This wide-acting glucocorticoid forms part of the stress response. Cortisol decreases inflammation, decreases protein stores, and increases protein synthesis in the liver.

Prednisone

A corticosteroid that mimics naturally produced cortisol. It reduces inflammation by suppressing the immune response and can be used to treat asthma.

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