Anabolic steroid effects on immune function

In order to understand how anabolic steroids effect the immune system, you must first understand how the immune system works.
The organs of the immune system are stationed throughout the body. They are generally referred to as lymphoid organs because that are concerned with the growth, development, and deployment or lymphocytes, the white cells that are the base of the immune system. These organs include bone marrow, thymus, lymph nodes, and spleen.

Immune cells, like all other cells, are produced in the bone marrow. There are two main classes of immune cells or lymphocytes as they are called. These are known as T cells and B cells. T cells mature in an organ know as the thymus. Most T and B cells congregate in the various immune organs, while other travel around in the blood stream.

The lymph nodes house both T and B cells. These cells work together though different mechanisms. They are very dependent on each other. By effecting one group of cells, you throw off the entire function of the immune responce. Now a little bit about B cells and T cells.

B cells work chiefly by secreting soluble substances called antibodies into the bodies fluids or humors. This is known as humoral immunity. Antibodies typically interact with circulating antigens such as bacteria and toxic molecules, but are unable to penetrate living cells. T cells interact directly with their targets, attacking body cells that have been commandeered by viruses.
There are different subsets of T cells which carry out various functions.

Each B cell is programmed to make one specific antibody. When a B cell manufactures millions of identical antibody molecules and pures them into the bloodstream. A given antibody matches a given antigen much as a key matches a lock. These antibodies indentify the antigen and mark it for destruction. Antibodies can work in several ways, depending on the nature of the antigen.

T cells contribute to the immune defenses in two major ways. Regulatory T cells do one thing and Cytotoxic T cells do another. Regulatory T cells are vital to orchestrating the elaborate system.
Cytotoxic T cells on the other hand directly attack body cells that are infected. T cells work directly by secreting substances known as lymphokines. Lymphokines call into play many other cells and substances, including the elements of the inflammmatory responce.

Once you under stand why T cells and B cells are dependent on each other, it is easier to understand how AAS effects this partnership. I will discuss this in the next thread. I do suggest that everyone do some research and understand this more specifically. I basiclly just summerized how the immune system functions.


Although I could not find any specific studies regarding how AAS effects immune function, I was able to piece together several articles and come up with a general idea of how this works.
The immune system has two basic types of defense cells. The B cells which make up the Humoral immunity, and T cells that make up the cell immunity.

First the T cells are formed in the thymus. These T cells work directly by attacking the invading virus. Explaining all the actions of T cells would take forever to do. If you want to do more, there are loads of info on this available at other sites. Most AAS are known to suppress Cellular immunity, although they stimulate humoral immunity.

What first brought this to my attention were the vast number of articles relating to using AAS to treat autoimmune diseases. Most autoimmune diseases are caused by various T cells attacking your own body.

Small doses of winstrol, and deca, have been shown to have no effect on the cellular immunity, but still improves humoral immunity. It is also know that many AAS including deca have been shown to be antiinflammatory. Although I believe that deca accomplishes this through a different function as compared to the rest. This is greatly because cellular immunity is what causes inflammation.

Viral Infection

A viral infection is any type of infection that is caused by a virus.

A virus is a germ that is smaller than a bacteria. Viruses are encapsulated by a protective coating so they are more difficult to kill than bacteria. They are harder to treat because they are not susceptible to antibiotics like bacteria are because of their protective coating. However, viruses cannot grow or exist without host cells - they must be in a living organism (such as the human body) to survive.

Common Viral Infections

Viral infections can cause illnesses as minor as the common cold and as severe as AIDS. Many times people will be diagnosed with a viral infection but not get any more specific information about the virus that is causing the symptoms. Usually when this happens, the symptoms are relatively minor and you will recover without any treatment. Health care providers don't always know the exact virus that is causing the illness. This is when you will get the diagnosis of a "viral infection" with no specific name.

Other common viral infections include:

    The Flu
    Viral Pneumonia
    RSV
    Croup
    Stomach Flu (Gastroenteritis)
    Chickenpox

Treating Viral Infections

Antibiotics do not kill viruses and the use of them for viral infections just leads to antibiotic resistance. There are only a few antiviral medications available to treat very specific viruses, and they are not always effective. In some cases steroids are effective.

However, there are vaccines available to help prevent many infections. If you have a minor illness and your health care provider tells you that it is a viral infection, the best thing to do is to treat the symptoms if you are able to and just let it run its course.

Anti-Inflammatory Medications in Cystic Fibrosis Treatment

Eventually, most people with any type of chronic lung disease will find themselves taking an anti-inflammatory medication at some point in their treatment. Anti-inflammatory medications improve breathing by reducing swelling of the air passages. Some anti-inflammatory medications are taken for short periods to help speed recovery when a patient has a respiratory infection or other problem causing a flare-up of breathing difficulty. Some anti-inflammatory medications are taken long-term to help prevent swollen air passages and improve lung function.

Corticosteroids vs. Anabolic Steroids

Corticosteroids: Medications that imitate the effects of a hormone produced in the adrenal gland called "cortisol," which has many functions in the body including fighting stress and reducing inflammation.

Anabolic steroids: Synthetic versions of male sex hormones that increase male characteristics. Athletes sometimes use them illegally to increase muscle mass and strength. There are legitimate medical conditions for which anabolic steroids may be prescribed, but lung disease is not one of them.

Oral steroids, such as prednisone, prednisolone or methylprednisone, are sometimes prescribed to people with cystic fibrosis (CF) for short-term treatment. They are not recommended for long-term therapy because of the potential for serious side effects including:

    Growth retardation in children
    Diabetes
    Cataracts
    Osteoporosis
    Decreased ability to fight lung infections, such as the potentially deadly Pseudomonas aeruginosa

Inhaled Steroids

Inhaled steroids, such as Qvar (beclomethasone), Pulmicort (budesonide) and Flovent (flucticasone), are delivered directly to the lungs and have less side effects than oral steroids. Studies have not shown any particular benefit of long-term inhaled steroids for people with cystic fibrosis, though, so the Cystic Fibrosis Foundation advises against the routine use of inhaled steroids in people with CF unless they also have asthma.

Steroids and HIV Infection

The connection between injection drug use and HIV infection is well known. Sharing injection equipment such as needles and syringes presents a real risk of transmitting HIV as well as Hepatitis C. However, the injection of steroids is often overlooked as a risk behaviour.

Unlike mood-altering drugs, steroids are not perceived as having any health risks and, therefore, the user does not think he/she is in any danger.
Who Uses Steroids?

The majority of users are high school students. Other users may include strip dancers, wrestlers, weight lifters, military personnel and prisoners. The use of anabolic steroids for cosmetic purposes far exceeds their use by athletes for competition. The preferred method of use is by injection rather than by mouth.

Steroid use is a short cut to self-esteem. It needs little investment in energy and its reinforcing results are almost immediate. In a society that places so much value on body image, steroids are seen as a quick and easy response to that pressure.
What Are The Risks?

Most of the negative effects of steroids are due to overuse or misuse. The side effects may include: liver damage, sexual difficulties, aggressive behaviour, depression, acne, muscle spasms and interference with normal growth. Some of the effects are reversible after discontinuing the steroid use. However, the very real health risks are from:

    sharing needles, syringes and vials
    improper injection site
    failure to clean injection site
    failure to ensure the needle is not in a vein or artery

Steroid users must be given the opportunity to decide for themselves the negative aspects of steroid use. Until they are ready to quit, it is essential to help our young people stay alive. Any discussion of HIV/AIDS should ensure that use of steroids is included as a risk behaviour. In addition, information on the proper use of injection equipment must be readily available.

When Are Steroids Indicated In Epstein-Barr Virus Infections?

Infectious mononucleosis, caused by Epstein-Barr virus, is generally characterized by a triad of pharyngitis, fatigue, and cervical lymphadenopathy. Fever and splenomegaly are also common in presentation. These are symptoms primarily manifested by the host response rather than direct viral infection. The severity and duration of symptoms are variable and most commonly resolve by 2 to 3 months postinfection. However, some such as lymphadenopathy and fatigue may persist. Treatment is generally supportive and con- sists of rest (although strict bed rest is not necessary), over-the-counter symptomatic relief for fever and throat pain, and avoidance of contact sports until the patient is asymptomatic and, if splenomegaly is present, you are no longer able to palpate the spleen.

The use of steroids for treatment of infectious mononucleosis has long been controversial.  The lack of clear evidence of benefit has led to universal recommendations indicating that steroids have no role in the routine use of treatment of infectious mononucleosis. However, despite this, steroids continue to be used somewhat liberally in uncomplicated cases, perhaps to hasten return to school and normal activities because of persistent symptoms, patient demand, or the physician’s personal experience, clinical judgment, or training. Steroids are not without adverse effects. Rare case reports have linked the use of steroids for routine mononucleosis with myocarditis, mostly mild and asymptomatic, but causing supraventricular tachycardia in one case,  and neurologic complications including meningoencephalitis, seizures, and brachial plexus palsy.

Most patients with an acute EBV infection have a self-limited course and recover without sequelae. Rarely, however, severe complications can occur in both healthy and immonocompromised patients. It is during these times that the use of steroids may, indeed, be warranted. Airway obstruction or impending airway obstruction is due to tonsillar hypertrophy and occurs in approximately 3.5% of patients but has been reported to occur in as many as 25% of cases.9 Massive splenomegaly and splenic rupture are the other most commonly feared complications. Although mild splenomegaly is quite a common finding in acute mononucleosis, found in approximately 50% of patients, serious splenic complications are very rare, occurring in less than 1%. Splenic rupture usually is found to occur during the second and third weeks of illness, at the peak of splenomegaly. Neurologic complications occur in less than 1% of patients. Two of the most common neurologic complications are encephalitis and cranial nerve palsies. Other neurologic complications that have been reported are aseptic meningitis, acute disseminated encephalomyelitis, transverse myelitis, Guillain-Barré syndrome, optic neuritis, and Alice-in-Wonderland syndrome (a perceived distortion of object size).10  Other life-threatening complications reported include myocarditis, fulminant hepatitis, and liver failure, and hematologic manifestations such as hemolytic anemia, idiopathic thrombocytopenic purpura, and hemophagocytic lymphohistiocytosis. These, and other life-threatening complications, are all indications for use of steroid therapy. Steroids have been used anecdotally and in small case series for these indications, but no rigorous studies have been performed to confirm the benefit of steroid use in these situations. Nevertheless, it is expert opinion that steroids may be useful for these potentially life-threatening complications of EBV infection.

Steroids to Treat Arthritis

What Conditions Are Treated With Steroid Injections?

Steroids often are injected directly into joints to treat conditions such as rheumatoid arthritis, gout, or other inflammatory diseases. They also can be injected into an inflamed bursa or around tendons near most joints in the body.

Some people report relief from osteoarthritis when steroids are injected directly into swollen or painful joints.

What Are the Expected Benefits of Steroid Injections?

Steroid injections into a specific area are generally well tolerated and are less likely than other forms of steroid drugs to produce serious side effects. Also, the injections may help avoid the need for oral steroids or increased doses of oral steroids, which could have greater side effects.

What Role Do Steroid Injections Play in an Overall Treatment Program?

Steroid injections can be added to a treatment program that may already include anti-inflammatory pain medications (NSAIDs), physical therapy, occupational therapy, or supportive devices such as canes and braces. Whether one or more of these treatment methods are used depends on the nature of the problem.

For example, in an otherwise healthy person, tendinitis may be adequately treated with only a steroid injection into the inflamed area. However, in a person with rheumatoid arthritis, injections are generally a small part of a multifaceted treatment approach.

When Should Steroid Injections Not Be Used?

Steroids should not be injected when there is infection in the area to be targeted or even elsewhere in the body because they could inhibit the natural infection-fighting immune response. Also, if a joint is already severely destroyed, injections are not likely to provide any benefit.

If someone has a potential bleeding problem or is taking anticoagulants (often referred to as blood thinners), steroid injections may cause bleeding at the site. For these people, injections are given with caution.

Frequent steroid injections, more often than every three or four months, are not recommended because of an increased risk of weakening tissues in the treated area.

How are viral diseases treated?

Treatment of viral infections varies depending on the specific virus and other factors. General treatment measures are aimed at relieving your symptoms so that you can get the rest you need to keep up your strength and recover without developing complications.

General treatments for viral infections include:

    Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) for fever, body aches, and pain

    Drinking extra fluids

    Getting extra rest and sleep

    Maintaining good nutrition

Depending on the type of viral infection and the presence of complications, a wide variety of other treatments may be needed. For example, a human papillomavirus (HPV) infection that leads to cervical dysplasia can be treated by surgical removal of the abnormal cells on a woman’s cervix.  

In general, it is recommended that children younger than age six not use cold or cough medications because of the risk for serious side effects. In addition, people with a viral disease should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as a cold or the flu.
Prescription medications used to treat viral diseases

In some cases, certain medications may be prescribed to treat viral diseases:

    Antiretroviral medications, which can help people with HIV/AIDS lead longer lives. Antiretroviral medications hinder the ability of HIV to reproduce, which slows the spread of HIV in the body.

    Antiviral drugs, which minimize the severity and length of some viral infections, such as the flu and shingles, especially in people who are at a high risk for serious complications. For example, the drugs oseltamivir (brand name Tamiflu) and zanamivir (brand name Relenza) may be prescribed for some cases of flu. These drugs are not appropriate for all people with the flu.

Antibiotics, which are not prescribed for viral diseases because they are ineffective in the treatment of viral infections, may be prescribed if a person with a viral disease develops a secondary bacterial infection, such as bacterial pneumonia, bacterial bronchitis, or encephalitis.
Complementary treatments

Complementary and traditional treatments will not cure a viral disease but may help to increase comfort, promote rest, and minimize symptoms of viral diseases.