“The problem with anabolic steroids is that they work,” says natural bodybuilder and content creator Jeff Nippard. And he’s right: In a landmark 1996 study on the effects of testosterone supplementation, scientists observed that people who took anabolic steroids gained vastly more muscle than “natural” individuals even without lifting weights. (1)
The incredible potency of anabolic-androgenic steroids (AAS) has caused them to explode in popularity in recent years, Nippard said in a Jun. 17, 2024 YouTube video. He’s right about that, too, but what about potential anabolic steroid side effects among bodybuilders?
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To determine how bodybuilders and recreational users alike interact with and manage the side effects of anabolic steroids, Nippard broke down the science and interviewed bodybuilding athletes with performance-enhancing drug (PED) experience. Let’s pull back the curtain and see what they had to say.
What Are Anabolic Steroids?
Nippard outlined the magnitude of AAS usage by comparing it to another widely used performance aid: creatine. But unlike creatine supplements which are available over the counter and have been shown to increase muscle mass when combined with strength training, (2) steroids provide a more-than-modest effect on muscle and strength.
- “You’d probably build about [10 times more] muscle by taking steroids,” Nippard noted.
Most anabolic steroids have a base “ingredient” of testosterone enanthate, or “test-E.” Injectable PEDs are often dissolved into some form of oil to help absorption. Many PEDs also contain aromatic compounds to prevent infection.
As Nippard explains, injecting AAS causes the testosterone molecules to make their way through the bloodstream and into muscle cells, where they enlarge the muscle, creating hypertrophy.
“If that’s all steroids did, I’d be on them,” Nippard joked. The side effects of anabolic steroids go far beyond the beneficial; that’s where Nippard turned to the experts.
Side Effects of Anabolic Steroids
“In theory, honesty [about steroid usage] is a good thing because it helps people manage their expectations,” Nippard said. However, he believes something more sinister is occurring in the real world — people, particularly younger folk, aren’t respecting the side effects of anabolic steroids.
To illustrate what can go awry by using and misusing anabolic steroids, Nippard tapped two industry experts with PED use experience: Dr. Mike Israetel and Derek, a content creator who operates the “More Plates, More Dates” YouTube channel.
[Steroid abuse] leads to adverse effects in all body tissues and organs.
Albano et al. (2021)
Before we dive into Nippard’s interviews, let’s briefly run through a list of clinically recognized anabolic steroid side effects. A 2021 meta-analysis concluded that anabolic steroid abuse leads to “…serious consequences in all body tissues and organs,” and cited a host of specific negative health outcomes as well: (3)
- Depression
- Mood swings
- Decreased HDL cholesterol
- Liver damage
- Increased rate of muscle strain
- Hypertension
- Thrombosis
- Impeded reproductive function
Anabolic Steroid Side Effects: Brain & Mood
“I have a severe anxiety disorder,” Dr. Israetel remarked to Nippard. Dr. Israetel is a PhD in Exercise and Sport Science at Lehman College and has extensive experience with anabolic steroid side effects throughout his years as a competitive bodybuilder.
“Most people aren’t aware of the side effects of steroids on IQ,” Israetel continued. Nippard backed Israetel’s claim by citing a 2021 study, (4) which revealed that weightlifters who used anabolic steroids had a large “brain-age gap”; their brains were aging faster than their bodies.
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Nippard touched on a bit of dramatic irony.
“Most people take steroids because they want to look and feel better,” he said, in contrast to a growing body of evidence that suggests a side effect of anabolic steroids includes poor self-image or body dysmorphia. (5)
Is Roid Rage Real?: Israetel marked a clear distinction here, saying that the stereotype of “roid rage” is more accurately characterized as an increase in aggression when taking certain anabolic compounds. “It very rarely materializes into violence, but the thoughts you have are disturbing.”
Anabolic Steroid Side Effects: Body, Metabolism, & Health
“You’re basically an adult with the raging libido of a 16-year-old,” said Derek of “More Plates, More Dates” (surname withheld by request). “It’s not ideal.”
However, Nippard and Derek also discussed the side effects of anabolic steroids that go beyond the mind and mood.
- “As you increase your strength, your connective tissues often can’t keep up, which increases your risk of injury,” Derek said. It’s a valid assumption: acute weight lifting injuries are rare, especially in comparison to many popular sports, (6) but lifters are susceptible to injury any time the load applied to a muscle, tendon, or bone exceeds its tolerance.
Regarding general health and lifespan, Nippard referenced a 2024 paper analyzing over 1,000 anabolic steroid users and found that anabolic steroid users died at a rate nearly three times above that of a non-steroid user. (7)
- “The excess death rate in this population of young adults is striking,” co-author Dr. Thomas L. Schwenk noted.
When Is the Right Time To Start Anabolic Steroids?
Despite the many well-known (and emerging) side effects of anabolic steroids, Nippard lamented that recreational usage seems to be only growing in popularity. This begs the question — is there a “right” time or age to start using steroids, and can you do so safely?
- “It’s a matter of managing the risk-to-reward ratio once you consider all of the factors that affect [steroid use],” said Derek.
Nippard prompted Dr. Israetel with a similar question. “There are certainly healthier and less-healthy ways to use steroids,” Israetel replied. “You’d want to start with very small amounts, check your blood work, consult with a medical doctor.”
- “People ask me about ‘hopping on’ at really young ages,” Nippard chatted to Israetel before asking if there’s a minimum age that he’d recommend anyone cross before they begin experimenting with steroids.
- Nippard’s rule of thumb is that someone should have at least ten years’ experience with bodybuilding workouts and training before considering AAS. Israetel agreed but added that people should not consider steroid usage if they’re below the age of 25.
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It may sound as though anabolic side effects are a risk factor that you can mitigate by making smart choices; both Nippard and Dr. Israetel agree on that.
However, Israetel shut the book on the idea with an analogy: “There are ways and precautions to race a car that make it safer, but once you’re going 200 miles per hour, ‘safer’ is the operative term. It was never safe to begin with.”
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FAQs
Are anabolic steroids safe now?
Despite advancements in medical science, anabolic steroid side effects remain commonplace and prevalent. Side effects range from reductions to life expectancy to hormonal disruption and hair loss. Anabolic steroid side effects depend greatly on the dosage and frequency of administration.
What do anabolic steroids actually do?
Most anabolic steroids are designed to increase muscular size, strength, or enhance athletic performance. Testosterone molecules in steroids are delivered into muscle tissue via injection or oral ingestion.
What are the side effects of anabolic steroids?
Side effects of anabolic steroids depend on the nature of the compound as well as dosage. Generally speaking, mild side effects include acne, hair loss, oily skin, or fluctuations in mood.
More severe anabolic steroid side effects can range from brain damage, infertility, and shortened life expectancy, among other chronic health conditions.
References
- Bhasin, S., Storer, T. W., Berman, N., Callegari, C., Clevenger, B., Phillips, J., Bunnell, T. J., Tricker, R., Shirazi, A., & Casaburi, R. (1996). The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. The New England journal of medicine, 335(1), 1–7.
- Delpino, F. M., Figueiredo, L. M., Forbes, S. C., Candow, D. G., & Santos, H. O. (2022). Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: A systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 103-104, 111791.
- Albano GD, Amico F, Cocimano G, Liberto A, Maglietta F, Esposito M, Rosi GL, Di Nunno N, Salerno M, Montana A. Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review. Healthcare (Basel). 2021 Jan 19;9(1):97. doi: 10.3390/healthcare9010097. PMID: 33477800; PMCID: PMC7832337.
- Bjørnebekk, A., Kaufmann, T., Hauger, L. E., Klonteig, S., Hullstein, I. R., & Westlye, L. T. (2021). Long-term Anabolic-Androgenic Steroid Use Is Associated With Deviant Brain Aging. Biological psychiatry. Cognitive neuroscience and neuroimaging, 6(5), 579–589.
- Scarth M, Westlye LT, Havnes IA, Bjørnebekk A. Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis among male weightlifters. BMC Psychiatry. 2023 May 16;23(1):342. doi: 10.1186/s12888-023-04781-1. PMID: 37193971; PMCID: PMC10186641.
- Keogh, J. W., & Winwood, P. W. (2017). The Epidemiology of Injuries Across the Weight-Training Sports. Sports medicine (Auckland, N.Z.), 47(3), 479–501.
- Windfeld-Mathiasen J, et al. Mortality among users of anabolic steroids. JAMA 2024 Mar 14.
Featured Image: @jeffnippard / Instagram
