“How much are subscriptions[for gym]?” and the question that often follows is: “How much are supplements?”

By Bakani M. Ncube

The gym craze and the desire for summer bodies is something that has become part of our culture. These summer bodies that are made in winter come at a cost though, and that cost involves something along the lines of waking up at 4:40am and having your clothes already laid out – the daily routine figured out: a workout, followed by the first of six meals which have been carefully weighed and packed and are to be ingested at very specific time intervals. After work, the gym bunny has to go back to the gym and be in bed early and ready to repeat the sequence the next day, and every day after that. This is the life most of us aren’t willing to live and yet we want those washboard abs.

When people subscribe to a gym, they usually walk up to the receptionist/trainer and ask “How much are subscriptions?” and the question that often follows is “How much are supplements?”. This is where my public health concern begins as “supplements” can become like a gateway drug for anabolic steroids. The pathway to steroid use for a lot of guys starts off with protein powder here, maybe they put some creatine with it, maybe then they think ‘God it’d be good to try testosterone booster’ says Scott Griffiths, a muscle dysmorphia researcher. He further says, “That familiarisation with using powders and pills to achieve your goals makes it more comfortable for you to eventually use steroids”. So what really are steroids?

According to Drug Facts, “Anabolic steroids are synthetic variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics”. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers.” Steroids are used clinically by healthcare providers to treat hormonal issues such as delayed puberty and to treat muscle wasting diseases such as AIDS and cancer. However, they are abused by some athletes and bodybuilders and now the ordinary guy in the gym who hasn’t looked natural in a while and this steroid abuse is done to boost performance, improve endurance and physical appearance. These steroids are usually taken orally or injected into the muscles (sometimes applied topically). The doses administered are usually 10-100 times higher than doses that would be prescribed to treat medical conditions. There is a belief that lacks scientific evidence that certain methods can be used to avoid any adverse events in the use of steroids and these are:

  • cycling—taking doses for a period of time, stopping for a time, and then restarting
  • stacking—combining two or more different types of steroids
  • pyramiding—slowly increasing the dose or frequency of abuse, reaching a peak amount, and then gradually tapering off

Short term effects of the use of anabolic steroids include mental problems such as paranoia, extreme irritability, delusions and impaired judgment. Extreme mood swings do also occur (“roid rage”) which are angry feelings and violent behaviour. Severe acne is also a problem with steroid use and it causes the body to swell, particularly the hands and feet.

Long-Term Effects

Anabolic steroid abuse may lead to serious, even permanent, health problems such as:

  • kidney problems or failure
  • liver damage
  • enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people

Several other effects are gender- and age-specific

In men:

  • shrinking testicles
  • decreased sperm count
  • baldness
  • development of breasts
  • increased risk for prostate cancer

In women:

  • growth of facial hair or excess body hair
  • male-pattern baldness
  • changes in or stop in the menstrual cycle
  • enlarged clitoris
  • deepened voice

In teens:

  • stunted growth (when high hormone levels from steroids signal to the body to stop bone growth too early)
  • stunted height (if teens use steroids before their growth spurt)

Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders. There is an increased risk of contracting or spreading HIV/AIDS or hepatitis among people who share needles that they use for injections.

Bakani M. Ncube is a second year pharmacy student, the Student Exchange Officer for ZPSA, Technical & Events Organizer for One Health and has a keen interest in Public Health.

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