Do Anabolic Steroids Cause Fungal Meningitis?

The recent fungal meningitis outbreak has been linked to contaminated methylprednisolone acetate (MPA) injections produced by the New England Compounding Center (NECC). The contaminated corticosteroid injections have resulted in 590 cases and 37 deaths. It has been a tragedy for the families involved. For anti-steroid crusaders, it has simply provided another tool to unfairly demonize anabolic steroids.

Various news media and anti-steroid organizations have erroneously included the risk of fungal meningitis as a possible side effect of anabolic steroids.

The Bay County Sheriff’s Office (BCSO) is the most recent agency to add to the unwarranted hysteria among users of black market anabolic steroids.
BCSO Captain Faith Bell cited the NECC case as the reason BCSO investigators were concerned about fungal contamination according to WMBB-TV in Panama City, Florida.
Potential to spread the fungus and bacteria was our main concern. In this case, that people would be injecting this stuff and within a short window of time be dead.
Whether out of willful ignorance or careless fact-checking, the irresponsible statements by the BCSO has contributed to the societal hysteria regarding anabolic steroids.
The truth is that there is essentially zero risk of non-medical anabolic steroid users contracting fungal meningitis.
MPA is a synthetic corticosteroid and NOT an anabolic steroid.
MPA are introduced directly into the central nervous system (CNS) via epidural injections.
Anabolic steroids are introduced into the muscular system via intramuscular injections.
The risk of fungal meningitis is rare.
The current outbreak was solely the result of a contaminated MPA solution being injected into the central nervous system.
Individuals injecting anabolic steroids intramuscularly are not at risk of being dead “within a short window of time” from fungal meningitis.
It is still important to note that there are significant risks associated with the potentially-contaminated injections of UGL anabolic steroids of unknown quality.
But fungal meningitis is not one of them.
The media has utterly failed to make any corrections or clarifications with regard to this matter.

Topical Steroids for Eczema Treatment

Topical steroids are used in addition to emollients for treating eczema. Topical steroids reduce skin inflammation. A short course will usually clear a flare-up of eczema. Side-effects are unlikely to occur with short courses.
What are topical steroids and how do they work?

Topical steroids are creams, ointments and lotions which contain steroid medicines. Topical steroids work by reducing inflammation in the skin. They are used for various skin conditions including eczema. (Steroid medicines that reduce inflammation are sometimes called corticosteroids. They are very different to the anabolic steroids which are used by some bodybuilders and athletes.)


What types of topical steroids are there?

There are many types and brands of topical steroid. However, they are generally grouped into four categories depending on their strength - mild, moderately potent, potent and very potent. There are various brands and types in each category. For example, hydrocortisone cream 1% is a commonly used steroid cream and is classed as a mild topical steroid. The greater the strength (potency), the more effect it has on reducing inflammation but the greater the risk of side-effects with continued use.

Creams are usually best to treat moist or weeping areas of skin. Ointments are usually best to treat areas of skin which are dry or thickened. Lotions may be useful to treat hairy areas such as the scalp.
When and how are topical steroids used?

As a rule, a course of topical steroid is used when one or more patches of eczema flare up. The aim of treatment is to clear the flare-up and then to stop the steroid treatment.

It is common practice to use the lowest strength topical steroid which clears the flare-up. So, for example, hydrocortisone 1% is often used, especially when treating children. This often works well. If there is no improvement after 3-7 days, a stronger topical steroid is usually then prescribed. For severe flare-ups a stronger topical steroid may be prescribed from the outset.

Sometimes two or more preparations of different strengths are used at the same time. For example, a mild steroid for the face and a moderately strong steroid for patches of eczema on the thicker skin of the arms or legs. A very strong topical steroid is often needed for eczema on the palms and soles of the feet of adults because these areas have thick skin.

You should use topical steroids until the flare-up has completely gone and then stop it. In many cases, a course of treatment for 7-14 days is enough to clear a flare-up of eczema. In some cases, a longer course is needed.

Many people with eczema require a course of topical steroids every now and then to clear a flare-up. The frequency of flare-ups and the number of times a course of topical steroids is needed varies greatly from person to person.

After you finish a course of topical steroid, continue to use emollients every day to help prevent a further flare-up. See separate leaflet called 'Emollients  for Eczema' for more details.
Short bursts of high-strength steroid as an alternative

For adults, a short course of a strong topical steroid may be an option to treat a mild-to-moderate flare-up of eczema. A strong topical steroid often works quicker than a mild one. Short-duration treatment to prevent flare-ups.

Some people have frequent flare-ups of eczema. For example, a flare-up may subside well with topical steroid therapy. But then, within a few weeks, a flare-up returns. In this situation, one option that might help is to apply steroid cream on the usual sites of flare-ups for two days every week. This is often called weekend therapy. This aims to prevent a flare-up from occurring. In the long run, it can mean that the total amount of topical steroid used is less than if each flare-up were treated as and when it occurred. You may wish to discuss this option with your doctor.

Drugs that can Harm the Immune System

The flu is rarely deadly. It's flu that becomes pneumonia that kills. Prescription and over-the-counter drugs should be seriously considered on the list of things that could potentially make people more susceptible to having a flu that morphs into a deadly pneumonia.

Steroids
All steroid drugs, from corticosteroids to anabolic steroids, suppress the immune system that defends against bacterial and viral infections such as pneumonia.

Chronic stress creates greater susceptibility to infection because it raises cortisol levels. Cortisol is a steroid hormone released by the adrenal glands that has many side effects when it’s chronically high. One side effect is that it reduces inflammation. At first glance that sounds good, but at the same time it suppresses the immune system. Chronically high cortisol also disrupts blood sugar balance, often leading to high insulin, obesity and sometimes, diabetes.

The most common route of steroid drug use, particularly in children, is through asthma inhalers.
Most asthma inhalers contain some form of synthetic steroid. These steroids help reduce the airway inflammation associated with asthma, but at the same time can reduce the ability of the lungs to fight bacterial and viral infections.

Steroid drug abuse among high school and college athletes is common. The National Institute on Drug Abuse estimates that 1 – 6% of high school athletes use steroid drugs to enhance their performance. This amounts to potentially hundreds of thousands of teens with suppressed immune systems who are more susceptible to viral and bacterial infection.

Steroid drugs such as prednisone are widely prescribed for people with painful inflammatory diseases such as arthritis, and for autoimmune diseases such as multiple sclerosis and lupus. They are also prescribed for those with organ transplants to suppress a rejection response by the immune system.

Even the regular use of cortisone creams for arthritis can raise cortisol levels enough to suppress the immune system.

 PPI Heartburn Drugs that Suppress Stomach Acid
Proton pump inhibitors or PPIs such as Nexium, Prevacid and Prilosec powerfully block the secretion of stomach acid. This has the effect of reducing heartburn and nausea, but it also blocks one of the body’s main defenses against bacteria and viruses. According to a 2004 study published in the Journal of the American Medical Association (JAMA), 70% of the hospitalized patients in the study received a PPI or other stomach acid-suppressing drug within hours of being admitted. The study showed that patients who were given PPIs had a 30% higher risk of developing pneumonia.

Statin Drugs to Lower Cholesterol
A medical group in Switzerland found that organ transplant patients who were taking statin drugs (e.g. Lipitor, Mevacor, Pravachol) did better than those who weren’t taking the drugs. Laboratory studies showed that statins did indeed suppress parts of the immune system, and the authors concluded, “This unexpected effect provides a scientific rationale for using statins as immunosuppressors, not only in organ transplantation but in numerous other pathologies as well.”

SSRI Antidepressants
The selective serotonin reuptake inhibitor antidepressant drugs (SSRIs) such as Prozac, Zoloft and Paxil increase serotonin levels and in so doing also give the immune system a boost. This boost can be the good news or the bad news. According to researchers at Georgetown University Medical Center, this boost can push the immune system into autoimmune disease, where the body starts attacking itself. These types of immune system over-reactions are also implicated in the “cytokine storms” that can create deadly inflammation in the lungs.

Opioid Drugs
Both short term and long term use of the pain killing opioid drugs such as hydrocodone, oxycodone, fentanyl, codeine and morphine block the immune system’s ability to attack viral and bacterial invaders. Some pain killing drugs such as Tramdol combine an opioid with acetaminophen (e.g. Tylenol), further compromising the immune system with acetaminophen’s toxic effects on liver function.