When former U.S. Sen. George Mitchell filed his report on performance-enhancing drug use in major league baseball, the majority of headlines and news went to 89 major league baseball players named in the report. What did not receive as much publicity in 2007 was the disheartening news of high school students abusing steroids and other performance enhancing drugs.
The Mitchell Report states that even the lowest estimates find “hundreds of thousands of high-school aged people are illegally using steroids.” Now steroids are once again in the headlines after current New York Yankees superstar Alex Rodriguez recently admitted to using them during his stint with the Texas Rangers.
Cook Children’s pediatric endocrinologist Joel Steelman, M.D., is concerned about the growing numbers of steroid users in the United States. The National Institute on Drug Abuse (NIDA) estimates that more than a half million eighth and 10th grade students are now using these dangerous drugs. Studies show mostly boys using anabolic steroids (about 3 or 4 to 1 for boys versus girls, depending on the study), with 1.3 percent of boys in the eighth grade taking steroids and increasing to 3.3 percent in 12th grade boys. Age use has been reported as young as age 9 years old.
Anabolic steroids are rarely used in pediatric endocrinology or any area of pediatrics. They also are the group of the growth-enhancing drugs most often misused for performance enhancement. Anabolic steroids also have the most side-effects that can occur when they are abused.
Dr. Steelman prescribes human growth hormone and testerone to patients only after confirmation of an underlying medical condition requiring their use. Treatment uses doses of these medications that have been studied now for decades, and frequent return medical visits are done for monitoring a patient while receiving treatment.
Dr. Steelman warns against young people taking any growth-enhancing drug without the guidance of a physician. He said the two main reasons teenagers begin taking these types of drugs are to gain an advantage in competitive sports or simply to look better to peers. Unfortunately taking steroids often come with a price.
Anabolic steroids have the most adverse side-effects to the body, according to Dr. Steelman. Short term side-effects include acne, gynecomastia (breast tissue development) in boys and mood changes. Girls may show a deepening in their voice as well as they stop having menstrual cycles.
“Mood changes not only include the so-called ‘roid rage’ that occurs while using steroid but includes depression symptoms when anabolic steroid use is stopped,” Dr. Steelman said. “The most serious side-effect of anabolic steroids is liver damage. The damage may be severe enough to lead to development of liver cancer after exposure, even at a young age.”
Misuse of testosterone or growth hormone is rare in the pediatric age range by virtue of the difficulty obtaining these medications as well as expense of these medications. Side-effects from excess testosterone overlap a good deal with negative effects from anabolic steroids. Growth hormone abuse has negative effects such as increased pressure in the brain, carpal tunnel syndrome, high blood pressure or elevating blood sugars.
Dr. Steelman has treated a teenager who abused anabolic steroids. “The side-effects from his misuse resulted in stunting his growth and may have contributed to his depression symptoms,” Dr. Steelman said. To patients considering taking steroids, Dr. Steelman said he stresses the importance of finding self-worth and fulfillment from within as a lifelong habit. He also discusses the high risk of irreversible damage that can occur.
“Then they may seek medical attention for further evaluation and begin discussion of treatment options,” Dr. Steelman said. “Depending upon the severity of the situation interventions, such as simple counseling versus counseling combined with medication therapy, may be needed.”
And while steroids receive the most attention as dangerous, Dr. Steelman said children should be concerned about other supplements they may put in their body – even over- the-counter items such as DHEA or Andro. “These are pre-hormones that supposedly are converted to testosterone” Dr. Steelman said. “Critical research on these supplements doesn’t support that they have much benefit. In addition, a good deal of Andro gets converted into estrogen as well as testosterone which can have negative side-effects in males.”
Dr. Steelman explains that combining supplements with stimulants like ephedrine or caffeine also are very popular, but they have not shown much benefit and have the risk of stimulant side-effects such as rapid heart rate or dizziness.
Even a supplement such as creatine, which has shown it can benefit some people in strengthening muscle, brings with it concern. “Side-effects are usually mild with creatine use, but there have been a few reports of kidney damage associated with creatine.”
