Steroids and Performance-Enhancing Supplements

  • Young men's version of this guide

The pressure to perform in high school and college sports continues to increase as student-athletes compete for scholarships and chase the dream of playing professionally. Unfortunately, some athletes at all levels of competition think that taking a performance-enhancing substance is an easy way to get ahead in sports. These substances can cause serious health problems for the athletes who use them. If you are considering taking any type of performance-enhancing substance, legal or illegal, we encourage you to check out this guide and talk with your health care provider so that you can understand the risks.

What is a “performance-enhancing substance”?

The term “performance-enhancing substance” refers to a variety of substances that athletes think may increase athletic strength.

Examples include:

  • Anabolic steroids
  • Stimulants such as caffeine and amphetamines
  • Diuretics
  • Dietary supplements such as creatine
  • Protein and amino acid supplements

What are anabolic steroids?

The terms steroids, “roids,” or “juice” usually refer to anabolic steroids, which are synthetic (human-made) substances similar to the male sex hormone testosterone. The term “anabolic” refers to muscle growth.

Anabolic steroids typically produce:

  • Increase in muscle mass and physical strength
  • Increase hair growth on the face or chest
  • Changes in the user’s voice

Users typically take a pill form or use a hypodermic needle to inject steroids directly into the blood stream. Although some steroids are used in medicine, anabolic steroids are illegal and are never prescribed to healthy young men or women.

Some common examples of anabolic steroids include:

  • Androstenedione
  • Dehydrochlormethyltestosterone (Turinabol)
  • Metandienone (Dianabol)
  • Methyltestosterone (Android)
  • Nandrolone (Durabolin)
  • Oxandrolone (Oxandrin)
  • Oxymetholone (Anadrol)
  • Stanozolol (Winstrol)

What are the health risks from taking anabolic steroids?

There are many negative health risks associated with anabolic steroids, such as:

  • Aggressiveness and increased anger
  • Baldness or hair loss
  • Enlarged breasts in men, loss of breasts in women
  • High blood pressure
  • Increased acne
  • Increased cholesterol levels
  • Increased risk of infections transmitted through blood such as HIV and Hepatitis if injected through a needle
  • Liver problems and tumors
  • Shrinking of the testicles, swelling of the clitoris
  • Facial and body hair growth

What are some of the warning signs that someone is taking anabolic steroids?

Steroids impact the level of hormones in the body, which can cause a wide range of emotions and behaviors that include:

  • Aggressive or violent behavior, aka “roid rage”
  • Mild depression
  • Irrational thinking

Where can I get help to quit taking steroids?

If you or a friend are abusing steroids, talk to an adult you can trust for help – a school counselor, a teacher, a coach, or your health care provider. Although it might be difficult to admit you have a problem, talking with someone is the first step to getting help.

What are stimulants? Are they safe?

Stimulants come in many forms such as:

  • Caffeine
  • Amphetamines (found in some cold medicines and prescriptions medicines to treat ADHD)
  • Illegal drugs such as cocaine and methamphetamines

These substances can cause an increase in:

  • Heart rate
  • Blood pressure
  • Metabolism (and loss of appetite)
  • Body temperature
  • Physical fatigue

Athletes mistakenly believe these substances will increase alertness or aggressiveness on the field. However, the negative side effects such as decreased concentration, nervousness or not being able to sleep can cause more serious problems for a player’s performance, not to mention the serious health risks.

What are diuretics? Are they safe?

Diuretics change the balance of fluids in the body and are sometimes used by wrestlers who are trying to compete in a lighter weight class.

These substances often lead to:

  • Dehydration (loss of water in the body)
  • Muscle cramps
  • Tiredness

What is creatine? Is it safe?

Creatine is a substance found naturally in the body and is believed to help supply energy to muscles and nerve cells. When taken as a supplement, creatine is believed to increase strength and help muscles recover faster during exercises that use short bursts of energy like sprinting and weight lifting. It also may reduce the amount of lactic acid (the stuff that makes you feel tired) produced during exercise. No research has shown improved performance in endurance sports (like running, swimming or biking)

The safety and effectiveness of creatine have not been tested in teens. Creatine is not recommended for teens or adolescent-aged athletes, even though it can be bought over-the-counter.

High doses can cause:

  • Upset stomach
  • Dehydration
  • Muscle cramps

What are protein and amino acid supplements? Are they safe?

For the majority of individuals, protein needs will be met through a balanced diet. Therefore, protein and amino acid supplements do not offer any added advantage over eating foods that are sources of protein (such as chicken, meat, fish, eggs, nuts, and tofu).

The risk in having protein and amino acid supplements is that they can contain illegal substances such as nandrolone, which might not be written on the ingredients label. Nandrolone is an anabolic steroid that is used in medicine but is not prescribed to healthy young men or women.

Your body can’t store protein for later use and it can’t effectively absorb more than ~30 grams at a meal, so consuming a large amount of protein supplements in addition to eating protein rich foods will ultimately be of no use in building muscle – the excess will be excreted through your urine. If you consistently exceed your protein requirements, you may be putting yourself at risk for kidney damage.

Are all performance-enhancing substances illegal?

  • Many performance-enhancing drugs, such as anabolic steroids, are illegal because of the health risks.
  • Many of these so-called “legal” or “natural” performance-enhancing substances have not been approved by the Food & Drug Administration (FDA), the office of our government that carefully researches the safety of products on the market. Taking a substance that has not been approved by the FDA could put your health at risk.
  • Even natural substances can produce negative side effects, especially when taken in high doses. While some dietary supplements are legal, the long-term effects of those substances may not be clear.

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.