The quick and dirty route to gaining strength is to take some kind of anabolic steroid. These drugs actually trick the body into building up muscle mass and endurance — but they can also age you far beyond your years.

Anabolic steroids work because they masquerade as one of the body’s basic hormones: testosterone.

Testosterone is, in fact, an anabolic steroid, and “anabolic-androgenic steroids” (the technical term for what most of us know as steroids) are just a synthetic version of this famous chemical. Anabolic refers to growth of muscles, and androgenic refers to male sex characteristics. We’ll call them anabolic steroids here, for accuracy’s sake.

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How do anabolic steroids make you stronger?

In general, steroids are chemical compounds that share a common structure. There are many types of steroids; anabolic steroids are only one of several that have roles to play in your body.

When you take anabolic steroids, your body breaks the drug down into molecules that can pass into your cells. There, the steroid molecules bind to structures called androgen receptors. This is where anabolic steroids really take on the role of testosterone, because androgen receptors are shaped very specifically to bind with the body’s natural testosterone. Anabolic steroids, however, can also bind with the receptors.

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Once this synthetic steroid is in place, the androgen receptor is activated. Depending on the type of cell the steroids are in, this activation can change how certain genes behave — especially the ones that control the changes that happen during puberty.

Steroids affect your normal metabolism in two basic ways, and together they result in greater muscle mass. Once those androgen receptors are activated, some cells increase their production of proteins, which your body uses to build more cells. This is the phase of your metabolic cycle known as anabolism, where small molecules build up into more complex ones and energy is stored. Anabolism is also when your body builds up muscles — so now you know why they’re called anabolic steroids. During anabolims, the cells in your skeletal muscles, or the powerful muscles attached to your bones, begin to replicate and grow. Soon, you’re building up strength and agility.

But not all activated androgen receptors cause this reaction. Some inhibit hormones called glucocorticoids, another type of steroid. Inhibiting glucocorticoids speeds up the breakdown of complex molecules like proteins into smaller units like energy-giving amino acids. The entire breakdown process is called catabolism, and it’s the other half of your metabolic cycle.

By inihibiting glucocorticoids, anabolic steroids shorten the catabolic phase of metabolism. That means your muscles spend less time recovering between workouts, and you can do more with less rest. You can see how steroids might improve athletic performance.

Do they work?

One study showed that men who used steroids for 10 weeks gained 2 to 5 kilograms of lean body mass — muscle, in other words. They also reported a 5% to 20% increase in strength. Study participants gained more muscle mass in their chest, next, shoulders, and upper arms than in other areas. That’s not because they skipped leg day, but because the muscles in these areas have more androgen receptors in their cells. Not surprisingly, the participants improved more noticeably at bench-pressing than in other kinds of weight-lifting.

Use and Misuse

Doctors prescribe anabolic steroids to patients with diseases like cancer and AIDS, to help them regain body mass they’ve lost to their illnesses. Anabolic steroids are also prescribed to help treat certain hormone deficiencies. It’s illegal to use anabolic steroids to improve athletic performance, but about 1% of the U.S. population has done it.

Using steroids without a prescription can cause unpleasant side effects that go beyond drug charges and being labelled a cheater. Mostly, they’re linked to the androgenic effects of these drugs, or those effects related to male sex characteristics. Basically, your body thinks it’s going through puberty again. Activating the androgen receptors in your cells increases oil production in your sebaceous glands, which leads to acne.

That said, overuse of anabolic steroids can also age you faster. It can lower sperm count and cause testicular atrophy, better known as shrinkage. Changing hormone levels can also lead to baldness in both men and women.

Then there are the cardiovascular problems. Because of the way they affect heart cells, anabolic steroids can cause chronic high blood pressure, as well as enlargement of the heart. Your cholesterol levels also get thrown out of balance, since your steroid-saturated body is producing more LDL cholesterol and less HDL cholesterol, which is the opposite of what the American Heart Association recommends. The hormonal effects of steroid use also increase your risk of prostate cancer (if you’re male) and can cause kidney and liver damage.

Besides the physical issues, anabolic steroids’ effects on the brain can lead to mood swings, irritability, and depression.

It’s not inherently more dangerous to use steroids without a prescription. The problem is that people who use anabolic steroids to enhance athletic performance often have no medical training, and thus engage in riskier behaviors than people who take them legally. They often take higher doses, for longer periods of time. Many people who take anabolic steroids this way also do reckless things like stacking, which involves combining several types of anabolic steroids in the hope of making them more effective (spoiler alert: bad idea).

Anabolic steroids are one of those superpowers that comes with a price. Bulking up with these drugs will actually weaken you in the long run.

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