Higher Steroid Hormone Levels in Pregnancy Can Cause Autism in Children

Researchers exploring the causes of autism have linked higher levels of steroid hormones in the womb during early fetal development to autism spectrum disorder.

These hormones, which play a key phase in brain development at three to four months of pregnancy, may also explain why the condition is far more common among males than females, they said.

But it was too early to say whether higher hormone levels were a cause of autism, the team wrote, and cautioned against hormone screening or treatment based on their preliminary findings.

Scientists at the University of Cambridge in Britain and Denmark's Statens Serum Institute analyzed hormone levels among nearly 20,000 stored samples of amniotic fluid, which surrounds the fetus in the uterus.

The team measured levels of four "sex" steroid hormones -- testosterone, progesterone, 17-alpha-hydroxy-progesterone and androstenedione -- which are known to play a role in brain development.

They also looked at a fifth hormone, cortisol, which is a marker of stress.

The researchers found higher hormone levels in the amniotic fluid in 128 males who were later diagnosed with autism spectrum disorder.

All autistic subgroups were found to have the signature: Asperger syndrome, classic autism or a category called unspecified pervasive developmental disorder.

"This is one of the earliest non-genetic biomarkers that has been identified in children who go on to develop autism," said Simon Baron-Cohen, a University of Cambridge professor.

"We previously knew that elevated prenatal testosterone is associated with slower social and language development, better attention to detail and more autistic traits.

"Now, for the first time, we have also shown that these steroid hormones are elevated in children clinically diagnosed with autism. Because some of these hormones are produced in much higher quantities in males than in females, this may help us explain why autism is more common in males."

It was not known what causes the higher steroid levels in the first place, and the team cautioned against using the findings as a tool to screen for autism.

Nor should drugs be used to block steroid hormones.

"This could have unwanted side effects and may have little to no effect," said Baron-Cohen.

Only males were tested in the first phase of research. The next step will be to see if a similar telltale exists for females.

"Steroid hormones are particularly important because they exert influence on the process of how instructions in the genetic code are translated into building proteins," co-researcher Craig Brierley said in an email exchange with AFP.

The study appeared in the journal Molecular Psychiatry.

The cause of autism, a complex neurodevelopmental disorder characterized by social withdrawal, is considered to be roughly split between genetic and environmental factors, according to a study last month in the Journal of the American Medical Association (JAMA).

Steroids Ineffective and Possibly Harmful in Pediatric Liver Disease

Treating infants with high doses of steroids fails to improve medical outcomes in the end-stage pediatric liver disease biliary atresia and leads to earlier onset of serious adverse events, says a new study.

Researchers say the clinical trial involving 14 sites provides new evidence on a growing controversy in the medical community - whether treating infants with steroids to augment surgery improves outcomes.

The results from this clinical trial differ from previous reports of a benefit from steroid therapy on bile drainage or survival in biliary atresia. Although it cannot be excluded some small potential benefit from steroid treatment, observed no statistical differences in two-year survival between patients receiving steroid treatment after surgery and those receiving placebo. Children receiving steroids during the study also developed serious adverse events more quickly, raising a potential increase in risks associated with steroid therapy.

Biliary atresia is the leading cause of pediatric liver transplantation in the world. The disease accounts for about 50 percent of transplants in children and 10 percent of transplants at any age. It results from inflammation and rapid accumulation of connective tissues that obstruct and restrict bile ducts from draining. The condition then manifests as cholestatic jaundice in the first few weeks after birth.

At diagnosis, the primary treatment is the hepatoportoenterostomy (HPE, the Kasai procedure) - a surgical procedure that removes the diseased bile ducts and gallbladder and connects an intestinal loop directly to the liver to restore bile drainage. Study authors point out that some clinicians suggest steroid treatment after surgery may help prevent additional fibrosis and improve bile drainage. The current study - called START (Steroids in Biliary Atresia Randomized Trial) - was designed to provide rigorous medical data to help answer that question.

The study involved 140 infants with a median age of 2.3 months. The initial study was conducted between September 2005 and February 2011, with follow up ending in January 2013.

Researchers report that in 70 children treated with steroids, bile drainage was not significantly different six months post-surgery compared to 70 children who received placebo after surgery. Of the 70 who received steroids, 41 of 70 patients (58.6 percent) had improved bile drainage. Of 70 patients who did not receive steroids, 34 of 70 (48.6 percent) had improved bile drainage.

When researchers compared survival rates between the steroid/non-steroid groups at age 24 months, 58.7 percent of children in the steroid group survived compared to 59.4 percent in the placebo group.

The percent of children who experienced serious safety events was relatively the same between the steroid group (81.4 percent) and non-steroid group (80 percent), but children who received steroids had an earlier time to onset for those events. Serious safety events occurred with 30 days post-surgery in 37.2 percent of children who received steroid treatment, versus 19 percent in the placebo group.

Potential serious safety events the authors pointed to included complications such as immunosuppression, associated risk of infection, poor wound healing, hyperglycemia, gastrointestinal bleeding, poor growth, and inadequate response to routine immunizations.

The Use of Human Growth Hormone in the treatment of HIV / AIDS

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). The HIV retrovirus may be passed from one person to another when infected blood, semen, vaginal secretions or other bodily fluids come in contact with an uninfected person's broken skin or mucous membranes. People with HIV have what is called HIV infection and are fit and well. Some of these people will develop AIDS as a result of their HIV infection.

Growth hormone is a popular bodybuilding and performance enhancing aid, and the use of recombinant human growth hormone (rHGH, or simply GH) to treat various conditions in HIV infection has been debated with excitement for years. Indeed it is licensed for the treatment of wasting syndrome in advanced stages of AIDS. GH is also a commonly used bodybuilding and performance enhancing drug, which can be purchased on the black market; used to help both muscle anabolism / strength and reduction in body fat levels. Both of these applications have possible significance in the treatment of HIV.

Other than in the treatment of wasting disease, results from the studies using rHGH to treat body changes associated with HIV and/or drugs used to treat HIV have been very favourable. One which has been studied extensively is the use of rHGH in reducing HIV-associated adipose redistribution syndrome (HARS). However, the positive effects of HGH treatment in HIV may be more direct. Several studies have proposed that rHGH may bolster the immune system in ways that might improve clinical outcomes in HIV.

Let's look at each of the possible treatment benefits of rHGH in HIV in turn:

HIV-associated adipose redistribution syndrome (HARS)
HARS is a type of lipodystrophy (abnormal distribution of body fat), where there is accumulation of excess truncal fat and visceral adipose tissue, as opposed to regular gynoid (glutes and hips) or android (abdomen) deposition. This is observed in HIV infected people, moreso as virus load increases. Although not a debilitating condition in itself (indeed extra body fat can prolong life if followed by wasting), HARS is unpleasant for the individual, giving reduced confidence in body image; another negative aspect of the disease.

rHGH therapy has been shown to significantly reduce HARS, leading to an improved body image, and significant improvement in psychological well-being. Numerous studies have demonstrated the benefits of this, leading to rHGH being licesenced for the treatment of HARS in some countries. It should also be noted that improvement in psychological well-being could also contribute to a positive clinical outcome, in that it reduces the effects of wasting.

Acute Infections
HIV patients are often more prone to acute infections which may take longer to clear up than in non-HIV individuals. Sometimes these can be associated with poor appetite and weight loss. rHGH therapy may curb rapid weight loss often associated with acute infections in HIV positive people and may also reduce length of infection. Far more research is needed here though.

Fasting lipid profile
HIV patients have been shown to have elevated serum lipids, and dyslipidaemia, i.e. high LDL (bad) cholesterol and low HDL (good) cholesterol with raised total cholesterol and triglycerides. This is associated with anti-HIV drug treatment especially later on in infection. This does increase risk of cardiovascular diseases, and rHGH treatment may improve lipid profiles.

Bone Building
HIV patients may have loss of bone density associated with wasting. Both treatment with rHGH and growth hormone releasing factor (GHRF) have indicated improved bone mass in HIV patients (Koutkia et al 2005).

Side effects of rHGH treatment
Although we have focused on the promising benefits for rHGH treatment in HIV infection, consideration of possible side effects is important in ensuring an informed decision can be made. Side effects of rHGH therapy include possible joint pain (arthralgia), abnormal growth of the body's extremities and impaired glucose intolerance, increasing the risk of type 2 diabetes.

Caution is also advised against using over-the-counter or faddy internet products that claim to contain human growth hormone. Some of them claim to contain plant-derived growth hormone, others claim to contain cow or goat growth hormone, and still others claim to contain substances that increase the body's production of GH. There is no evidence that any of these products contain either a relevant product or a dose needed to induce the types of effects seen in studies. Over-the-counter and internet sales of these 'growth hormone' products are a major source of health fraud.

Certainly rHGH has shown benefits in treating wasting syndrome in advanced stages of HIV disease or AIDS, and its approval as a treatment for body lipodystrophy is encouraging. However, it's important that larger studies confirm these early findings. They can tell us whether or not increases in thymus size and CD4+ cell numbers, associated with rHGH use, ultimately benefit people living with HIV and result in better quality of life and longer life. Treatment with GH in HIV is encouraging and exciting, but far more research is still required.

How to Protect the Liver During Anabolic Steroid Use

Liver harm from anabolic steroids comes principally or entirely from alkylated anabolic steroids. Where the steroids are non-alkylated and estradiol levels remain normal, there’s almost never harm to the liver from steroid use.

Example non-alkylated steroids are testosterone, Masteron, trenbolone, boldenone (Equipoise), nandrolone (Deca Durabolin), and Primobolan.

Keeping liver safety in mind, an effective cycle should have one or more of these steroids as the base, or even as the entirety of the cycle.

About 350-700 mg/week of a steroid stack, though, may be an alkylated compound. The most common alkylated steroids are Dianabol, Anadrol, oxandrolone (Anavar), and Winstrol.

Alkylated steroid use is preferably limited to only six weeks at a time, though of course many who go longer don’t suffer lasting harm. However, sustained use of oral anabolic steroids absolutely can cause undetected formation of scar tissue in the liver. This effect can be cumulative, as the scar tissue does not heal. And thoroughly excellent gains can be achieved without “pushing” the 6-week rule.

If cycle length is greater than 6 weeks, then appropriate amounts of testosterone can substitute for the orals. I replace Anadrol or Winstrol with testosterone on a milligram for milligram basis. I replace Dianabol on a three-to-two basis, or in other words, 50 mg/day Dianabol is replaced by about 75 mg/day of testosterone.

Oxandrolone, on the other hand, is replaced with Masteron on a three-to-two basis, or trenbolone on a two-to-three basis.

Each period of alkylated steroid use should be followed by about twice as much time not using alkylated steroids, or longer.

Estradiol preferably will be kept in the normal range, or not much above it, as elevated estradiol is slightly liver toxic. In and of itself estradiol toxicity is not greatly important, but in combination with alkylated steroid use, it adds to the toxicity.

Obviously hepatotoxic drugs and excessive alcohol use should be avoided, as should heavy use of NSAID’s, aspirin, or acetaminophen. Cautious use is fine.

In terms of supplementation for liver health, lecithin may be taken in amounts such as 3-7 g/day together with B vitamins. With regard to milk thistle, steroid-induced cholestasis results from reduced activity of the bile salt export pump, and silymarin and silibinin (components of milk thistle) act at this point and can partially block the adverse effects of steroids. However, cheap milk thistle products don’t provide much of these substances.

Liver protection supplementation may safely be omitted when the above principles are followed. Supplementation shouldn’t be a license to use alkylated steroids less carefully.