Anabolic Steroids and Performance-Enhancing Drugs
A clinical reference on Nandrolone, Stanozolol, Testosterone, and hGH — substances diverted from medicine into gyms and athletics for performance enhancement.
Part 10: Anabolic Steroids and Performance-Enhancing Drugs
Clinical Reference for Healthcare Professionals.
1. Nandrolone Decanoate
| Field | Detail |
|---|---|
| INN / Salt | Nandrolone Decanoate |
| Drug Class | Anabolic-Androgenic Steroid (AAS) |
| Schedule | Schedule H / Schedule X (depending on formulation) |
| Indian Brands | Deca-Durabolin (Organon), Nandrobolin |
| Legitimate Uses | Aplastic anemia, osteoporosis, cachexia (wasting) in chronic illness |
Mechanism of Action
Nandrolone binds to the androgen receptor, promoting protein synthesis, nitrogen retention, and muscle growth (anabolic effects). It also has mild androgenic (masculinizing) effects. Its decanoate ester provides a sustained release over 2-4 weeks from a single intramuscular injection.
Why It Is Abused
Nandrolone (“Deca”) is one of the most widely abused anabolic steroids in Indian gyms and bodybuilding circuits. It promotes dramatic muscle growth and recovery. Users typically stack it with Testosterone and other steroids in “cycles” lasting 8-16 weeks.
Side Effects & Dangers of Abuse
- Cardiovascular: Dyslipidemia (elevated LDL, reduced HDL), left ventricular hypertrophy (thickened heart muscle), increased risk of heart attack and stroke.
- Hepatotoxicity: Liver damage, particularly with oral steroids.
- Hormonal Disruption: Testicular atrophy, oligospermia (reduced sperm), gynecomastia (male breast tissue growth), and infertility.
- Virilization in Women: Deepened voice, facial hair growth, clitoral enlargement (often irreversible).
- Psychiatric: Aggression (“roid rage”), mania, depression upon cessation.
2. Stanozolol
| Field | Detail |
|---|---|
| INN / Salt | Stanozolol |
| Drug Class | Anabolic-Androgenic Steroid (17-alpha-alkylated) |
| Schedule | Schedule X |
| Indian Brands | Menabol, Winstrol (imported) |
| Legitimate Uses | Hereditary angioedema (HAE), aplastic anemia |
Mechanism of Action
Stanozolol is a synthetic derivative of dihydrotestosterone (DHT). Unlike Nandrolone, it does not aromatize (convert to estrogen), making it popular for “cutting” cycles (fat loss while preserving muscle). It is hepatically active (17-alpha-alkylated), meaning it survives first-pass metabolism when taken orally.
Why It Is Abused
Stanozolol (“Winny”) is the steroid most associated with competitive athletics doping scandals. It dramatically increases strength and lean body mass without the water retention associated with Testosterone. It is widely available in Indian underground steroid markets.
Side Effects & Dangers of Abuse
- Severe Hepatotoxicity: 17-alpha-alkylated steroids are directly toxic to the liver. Prolonged use causes peliosis hepatis (blood-filled cavities in the liver), cholestasis, and hepatocellular carcinoma (liver cancer).
- Joint Pain: Stanozolol reduces synovial fluid, causing painful, dry joints — a paradox for athletes.
- Tendon Rupture: Increases muscle strength faster than tendon adaptation, leading to catastrophic tears.
- Cardiovascular: Extreme dyslipidemia (cholesterol imbalance).
3. Testosterone (Various Esters)
| Field | Detail |
|---|---|
| INN / Salt | Testosterone Undecanoate / Enanthate / Cypionate / Propionate |
| Drug Class | Anabolic-Androgenic Steroid (Natural Androgen) |
| Schedule | Schedule H / Varies by formulation |
| Indian Brands | Sustanon 250 (blend), Testoviron Depot, Cernos Depot, Andriol |
| Legitimate Uses | Male hypogonadism, delayed puberty, transgender hormone therapy (FtM) |
Mechanism of Action
Testosterone is the primary natural male sex hormone. Exogenous administration binds to androgen receptors, promoting muscle growth, bone density, red blood cell production, and secondary sexual characteristics.
Why It Is Abused
Testosterone is the “base” of virtually every anabolic steroid cycle. Bodybuilders and athletes use supraphysiological doses (5x to 20x normal replacement doses) to build extreme muscle mass. It is the most commonly prescribed and diverted steroid globally.
Side Effects & Dangers of Abuse
- Polycythemia (Erythrocytosis): Dangerously high red blood cell count, increasing the risk of blood clots, stroke, and pulmonary embolism.
- HPTA Suppression: The hypothalamic-pituitary-testicular axis shuts down. Endogenous testosterone production ceases. Upon cessation, severe hypogonadism ensues (depression, fatigue, loss of libido, muscle wasting).
- Acne and Skin Changes: Severe cystic acne, particularly on the back.
- Male Pattern Baldness: Accelerated in genetically predisposed individuals.
4. Human Growth Hormone (hGH / Somatotropin)
| Field | Detail |
|---|---|
| INN / Salt | Somatotropin (recombinant hGH) |
| Drug Class | Peptide Hormone |
| Schedule | Schedule H |
| Indian Brands | Humatrope, Norditropin, Genotropin (imported), various Indian generics |
| Legitimate Uses | Growth hormone deficiency (pediatric and adult), Turner syndrome, short bowel syndrome |
Mechanism of Action
hGH stimulates the liver to produce Insulin-like Growth Factor 1 (IGF-1), which mediates most of its growth-promoting effects — cell proliferation, protein synthesis, fat metabolism, and bone growth.
Why It Is Abused
hGH is used in bodybuilding for its fat-burning, muscle-building, and “anti-aging” effects. Unlike steroids, it is extremely difficult to detect in standard anti-doping tests. It is also marketed in underground “wellness” clinics as an anti-aging therapy.
Side Effects & Dangers of Abuse
- Acromegaly: Abnormal growth of hands, feet, jaw, and internal organs (cardiomegaly).
- Insulin Resistance / Type-2 Diabetes: hGH directly antagonizes insulin action.
- Carpal Tunnel Syndrome: Joint pain, fluid retention.
- Potential Cancer Risk: IGF-1 promotes cell proliferation, potentially accelerating dormant cancers.
Return to Index: Drugs of Abuse: Clinical Reference Guide
Comments
Recently Viewed
Related Posts
Drugs of Abuse: A Clinical Reference Guide for Healthcare Professionals
An educational pharmacology reference cataloging prescription and OTC drugs commonly diverted for recreational misuse, organized by drug class with salt names, mechanisms, side effects, and Indian scheduling.
Opioids (Mild): Codeine, Tramadol, and Tapentadol
A clinical pharmacology reference on Codeine, Tramadol, and Tapentadol — their legitimate uses, mechanisms, why they are abused, side effects, and Indian scheduling.
Opioids (Strong): Morphine, Fentanyl, Pethidine, and Buprenorphine
A clinical pharmacology reference on the strongest opioid analgesics — their legitimate uses, mechanisms, why they are diverted, side effects, and Indian scheduling.