How do anabolic steroids interact with the immune system?

High doses of anabolic steroids reduce the amounts of immune globulin A, G, and M in the blood. These proteins, known medically as IgA, IgG, and IgM, are part of the body's humoral immune system. These antibodies that circulate in the bloodstream and attack invading bacteria. Having fewer of them may make a person more likely to develop a serious infection.

Steroid injection can carry many kinds of bacteria and viruses past the protective skin and into the blood, causing infection. The use of syringes without strict sanitary and sterile conditions
can transmit infectious hepatitis, a life-threatening disease. Needle-sharing can lead to AIDS and other blood-borne diseases. There are two documented cases of AIDS transmission traced to needle-sharing in the gym.

By contrast, anabolic steroids increase the activity of the natural killer cells. Another of the body's defenses against infection, natural killer cells are specialized white blood cells that attack specific viruses and bacteria and help to prevent tumor formation. Increased natural killer cell activity could be helpful to the body.
However, overactive natural killer cells could also attack the body's own tissues, leading to diseases that are known medically as "autoimmune diseases."

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.

Anabolic Steroids Used for Weight Gain of HIV Patients

People with HIV suffer from a condition referred to as HIV wasting. This condition is characterized by involuntary loss of about 10% of the total body weight, often coupled with prolonged diarrhea, fever, or weakness. In HIV wasting, the weight loss is attributed to the loss of lean body mass or muscle mass.anabolic steroids

HIV wasting is caused by several factors, one of which is reduced food intake. HIV patients usually consume less food because they have low appetite. Furthermore, the medicines they take also have side effects that make them eat less.

Another factor that causes wasting in HIV patients is that their small intestine, affected by infections brought about by the disease, does not absorb nutrients effectively anymore. Finally, HIV patients experience wasting because their body?s metabolism is altered. The disease affects the way their body processes food and builds up protein.

A study conducted in 2005 showed that HIV patients have a chance to gain the weight they lost to wasting. This can be made possible by treating them with anabolic steroids.
The study involved HIV patients with ages ranging from 24 to 42. A total of 294 individuals were given anabolic steroids, which they took for 6 weeks, while 238 individuals were given the placebo. At the end of the study, those who took the anabolic steroids showed weight gain of almost three pounds.

According to medical experts, this amount of weight gained because of steroid intake is clinically relevant. This positive result has birthed the hope that more of the weight lost because of wasting can be regained by longer treatment of anabolic steroids.

Although more research is needed to establish this principle, the result of the study definitely brings good news to HIV patients. Scientists and medical experts have been trying for a long time to reverse the effect of HIV wasting, which can lead to extreme muscle loss and weakness. Wasting can even cause organs to fail and make the patient die more quickly. People with HIV or AIDS suffer from reduced testosterone levels, and their bodies are unable to build muscle mass.

So what are anabolic steroids? These are synthetic steroids that have the same characteristics as testosterone, which is the male sex hormone. They help the body to grow skeletal muscles.

Anabolic steroids have been made largely unpopular primarily because athletes misuse and abuse these products. However, they do have important medical applications and are being used to treat certain medical conditions like low testosterone level for men and anemia. Now this study involving the use of anabolic steroids for the treatment of HIV wasting proves once again that these substances have a significant role in the field of medicine.

In this study, the patients either took the anabolic steroids orally or through an injection. The side effects reported include acne, mood swings, slight increase in growth of body hair, aggressiveness, abnormal liver function tests, and irritability, which are all common manifestations of using anabolic steroids.

More study is needed to confirm if the weight gain caused by anabolic steroid intake will bring about an improvement in the patient?s quality of life. Experts also still need to determine how much gain weight translates to a successful result of treatment with anabolic steroids.

Human Diseases Caused by Viruses

When a cell is infected with a virus several effects may be seen. Many viruses cause no harm or disease whatsoever. However, some viruses may attack certain cells and multiply within them.

Once mature the daughter viruses break the cell and spread elsewhere. This is called a lytic infection. Eventually, if host immunity operates effectively, the virus-infected cell may be killed by the host, leading to interruption of the virus cycle and cure of the infection. However, this is not true for all viral infections.

The viruses may persist in the cell without damaging it and make the cell a carrier. The patient may appear to be cured but the infection persists and can spread to others. In addition, the infection may reappear later after this period of lull or latency.

Spread of viruses
Viruses cannot exist on their own and for survival they need to spread to another host. This is because the original host may either die or eliminate the infection. Some important routes of viral transfer include:
Route                                                                     Examples
Skin contact                                                         HPV (warts)
Respiratory                              Cold virusues, influenza, measles, mumps, rubella
Faecal-oral                                 Polio, echo, Coxsackie, Hepatitis A, Rotavirus
Milk                                                                 HIV, HTLV-1, CMV
Transplacental                                                Rubella, CMV, HIV
Sexually                                           Herpes 1 and 2, HIV, HPV, Hepatitis B
Insect vector                                            Yellow fever, Dengue fever
Animal bite                                                              Rabies

In addition, in order to spread the viruses also need to withstand the immune system. A special category of viruses is those that cause disease only when the immune system is deficient in some way; these are called opportunists, and  opportunistic infection is one of the main problems in patients with, for example, AIDS.

Where do viruses reside?

There are several viruses that have an animal or plant reservoir from where they affect humans. Some of the common reservoirs of viruses include;
Virus                                                            Animal reservoir
Influenza                                                     Birds, pigs, horses
Rabies                                                          Bats, dogs, foxes
Lassa and Hanta viruses                                    Rodents
Ebola and marburg viruses                               Monkeys
HIV-1 and -2                                            Chimpanzees, monkeys
Newcastle disease                                              Poultry
West Nile virus                                                     Birds


Host defence to viral infections
The body's first line of defence against viruses is the innate immune system. This is made up of cells and other mechanisms that defend the host from infection. This provides a temporary protection against the viral onslaught.

Once within the adaptive immunity faces the virus and remembers it. This is a more permanent form of immunity that may last a life time against the particular strain of virus. Specific antibodies are produced against the virus.
 This is called humoral immunity.

Two types of antibodies are important. The first called IgM is highly effective at neutralizing viruses but is only produced by the cells of the immune system for a few weeks. The one that lasts a life time is the IgG antibodies.

The second line of defence is called cell-mediated immunity and involves immune cells known as T cells. T cell recognises a suspicious viral fragment there and the killer T cells destroy the virus.

Virus spread control
Viral diseases can be prevented from spreading by vaccinations and the most successful of these is the small pox vaccine that has completely eradicated the disease in 1980. It is hoped that several other viruses, such as polio and measles, will follow.

Epidemics and pandemics of viral infections
Spread or outbreak of a viral infection in a community is termed an epidemic. A pandemic occurs when there is a worldwide epidemic.

The 1918 flu pandemic, commonly referred to as the Spanish flu was such a pandemic. It was caused by an unusually severe and deadly influenza A virus. The victims were often healthy young adults in contrast from weakened and elderly who are usual victims. It killed around 100 million people or at least 5% of the world's population in 1918.

HIV is now considered a pandemic with an estimated 38.6 million people now living with the disease worldwide.

Viruses and cancer
Some viruses may incorporate their DNA (or DNA copied from viral RNA) into host DNA, with effects on the control of cell growth. This may sometimes lead to transformation, in other words a tumour.

However, integration does not always lead to transformation and is not mandatory for transformation. The association of viruses with tumours in animals was first suspected 90 years ago but only in the 1960s was a virus (EBV) shown convincingly to be associated with a human tumour (Burkitt’s lymphoma).

Now the role of oncogenes that are activated for causing cancer is being better understood to know why all viruses and all infections do not cause cancer in all individuals.

Treatment of viral infections
Several antiviral drugs that are used to treat viral infections have been developed over the past two decades. Many of these are focussed against HIV. These do not cure HIV infection but stop the virus from multiplying and prevent the progress of the disease. Another notable antiviral drug is Ribavarin against hepatitis C.

Viruses in general are notoriously difficult drug targets as they modify and adapt themselves rapidly to build up a resistance against the drug. Case in point is Oseltamivir (trade name - Tamiflu) used in influenza.

Viral Meningitis Basics

Less serious than bacterial meningitis, viral meningitis is associated with a number of infections, including chickenpox, Lyme disease, and even rabies.

 Meningitis occurs when the lining protecting the brain and spinal cord — called the meninges — becomes inflamed. There are two main kinds of meningitis, bacterial meningitis and viral meningitis. Bacterial meningitis is a potentially fatal condition that can have severe after-effects, including brain damage, deafness, limb amputation, and stroke. Viral meningitis, also called aseptic meningitis, is milder and more common than bacterial meningitis, rarely has any long-term after-effects, and is seldom fatal. Statistics vary, but it is thought that viral meningitis causes between 25,000 and 50,000 hospital visits each year in the United States.

Children are more likely than adults to get viral meningitis. Children under the age of 5 are most vulnerable.

Causes of Viral Meningitis

Nearly 90 percent of viral meningitis cases are caused by viruses in the enterovirus family, which is a group of common viruses. The viruses usually enter the body through the mouth and then travel to the brain and tissues around it. Coxsackie viruses and echoviruses are among the primary offenders.

Other viruses that can cause viral meningitis are:

    Chickenpox virus (varicella virus)
    Mumps virus
    West Nile virus
    Viruses transmitted by bites from infected mosquitoes
    Rabies virus
    Type 1 and type 2 herpes viruses
    HIV

Meningitis can also be caused by a direct infection of the meninges.

Symptoms of Viral Meningitis

Viral meningitis has symptoms that are similar to the flu:

    Severe headache
    Stiff neck
    Eyes sensitive to light
    Chills
    Fever
    Muscle pain
    Sore throat
    Drowsiness
    Confusion
    Rash
    Abdominal pain, nausea, and vomiting

Symptoms may last anywhere from a week to 10 days.

Treating Viral Meningitis

As with other viruses such as the common cold, the symptoms of viral meningitis can be managed by resting, drinking plenty of fluids, and taking medication to relieve symptoms. These measures will help you feel more comfortable, but they don’t actually cure the infection.

If the meningitis is caused by a very contagious virus such as chickenpox, your doctor will prescribe antiviral medication.

Most patients recover completely from viral meningitis although, in some cases, the patient may experience continuing headaches, fatigue, and depression.

Is Viral Meningitis Contagious?

Yes. The most common causes of viral meningitis, enteroviruses, are spread when there is direct contact with an infected patient’s saliva, mucus, or sputum. This can happen when you touch a person or object that is infected and then touch your own nose or mouth. Viral meningitis is also spread by coughing and sneezing.

The stool of someone who is infected can also carry the virus. In this case, the virus is spread primarily among young children who haven’t been toilet trained. Adults who change diapers of an infected baby may also catch the virus.

Remember that catching an enterovirus doesn’t mean it will develop into viral meningitis. In fact, fewer than 1 in 1,000 people who get sick from one of the viruses associated with viral meningitis go on to develop it.

How to Prevent Viral Meningitis

There are several ways to reduce your chances of getting a virus that can turn into meningitis:

    Get vaccinated. Be sure that you and your children have been vaccinated against measles, mumps, and rubella (the MMR vaccine), and chickenpox — all viruses that can cause meningitis.
    Avoid mosquitoes. Because mosquito-borne viruses can cause meningitis, using insect repellant and avoiding the outdoors during periods when mosquitoes are most active (dusk to dawn) is important.
    Wash your hands. Another crucial way to avoid being infected is to be mindful of personal hygiene. Wash your hands thoroughly with soap and warm water after you sneeze, cough, shake hands, use the toilet, and change diapers. Also be sure to wash your hands before you cook or eat.
    Disinfect. If you are around someone who has viral meningitis, clean and disinfect surfaces and objects, first with soap and water, and then with bleach that contains chlorine. (Mix about a quarter of a cup of bleach to a gallon of water.)

Remember, your best chance of avoiding viral meningitis is to be vaccinated against diseases known to cause viral meningitis and to wash your hands regularly. Thorough hand-washing can protect you from not only viral meningitis, but lots of other diseases.