Former anabolic steroid users are more likely to develop heart disease

Not only can anabolic steroids cause serious side effects during use, such as heart failure and depression, but they can continue to be harmful years after stopping, according to two studies presented at the 25th European Congress of Endocrinology in Istanbul. These studies, supported by the Novo Nordisk Foundation, were carried out by researchers from Copenhagen University Hospital Rigshospitalet who investigated the effect of anabolic steroids on former users.

Anabolic steroids — synthetic hormones that mimic the naturally occurring sex hormone testosterone — are used to increase muscle mass and enhance athletic performance. These performance-enhancing drugs have adverse side effects, for example in men, that include breast growth, hair loss, decreased testosterone levels, erectile dysfunction, and an increased risk of heart disease, stroke, and liver or kidney failure. However, not much is known about the effects years after stopping its use.

In one study, researchers examined 64 healthy men, ages 18 to 50, who did recreational strength training in Denmark. Of these men, 28 men were using anabolic steroids, 22 were former steroid users, and 14 had never used anabolic steroids. The researchers assessed the amount of blood flowing to the heart muscle at rest and with exercise, using positron emission computed tomography (PET-CT) with the radioactive tracer Rubidium-82, and found that both past and current users had impaired blood flow to the heart.

The results indicate that former steroid users are more likely to develop heart disease when compared to those who have never used them before.

Previous studies have shown that cardiac function returns nearly to normal after anabolic steroids are discontinued, but our study indicates that former anabolic steroid users are at increased risk of developing heart disease years after stopping as the heart’s microcirculation – blood flow through the smallest blood vessels in the circulatory system. System – Consistently seems poor. Previous use of anabolic steroids could be a novel risk factor for cardiovascular disease.”

Dr. Yeliz Bulut, lead author

In another study, Dr. Bulut and colleagues collected questionnaires and blood samples to measure testosterone levels from three groups of men, ages 18 to 50: 89 current steroid users, 61 former steroid users, and 30 men who had never used anabolic steroids before. They found that former users of anabolic steroids reported worse quality of life on their physical and mental health, such as fatigue, social functioning and emotional well-being, even though they stopped years earlier. In addition, the same group had lower levels of testosterone than those who had never used anabolic steroids.

Previous studies have shown that men experience withdrawal symptoms, such as depression and decreased motivation, and have lower levels of testosterone, once they stop using anabolic steroids. “Our study adds to the growing body of literature that poor quality of life in former anabolic steroid users appears to persist for years after cessation and can be caused by both withdrawal and/or symptoms of hypogonadism due to a sudden drop in serum testosterone levels,” said Dr. Bulut. “Unfortunately, the reported poor quality of life can be a reason for former users to start using these stimulants again.”

Both studies included a small number of anabolic steroid users, former users and non-users. Dr. Bulut and her team now plan to recruit more men for studies to assess each of these links with more widespread prior steroid use. “Our preliminary findings show that former anabolic steroid users are more likely to develop heart disease and have a reduced quality of life but we need to confirm these findings with larger studies and investigate how risks change in relation to years of use and/or cessation,” said Dr. Bulut. “The steroid side effects among former users appear to last much longer than we know so far. We hope that our findings on these long-term health risks will prevent men from using anabolic androgenic steroids.”