Steroids are chemical compounds, both natural and synthetic, influencing various bodily functions. This article explores how certain types can impact liver health, detailing their specific effects and potential risks.
Steroid Types and Liver Effects
Steroids relevant to liver health primarily fall into two main categories: anabolic-androgenic steroids (AAS) and corticosteroids. AAS are synthetic testosterone derivatives, commonly used for muscle building and performance enhancement. Their use is strongly associated with liver injury, including cholestasis (impaired bile flow) and peliosis hepatis (blood-filled cysts). Prolonged AAS use has also been linked to liver tumors like hepatic adenomas and, less commonly, hepatocellular carcinoma.
Corticosteroids (e.g., prednisone, dexamethasone) differ from AAS, prescribed for anti-inflammatory and immunosuppressive properties. While less directly damaging, long-term use can cause hepatic enlargement and steatosis (fatty liver). They may also worsen pre-existing liver conditions, such as nonalcoholic steatohepatitis, and exacerbate chronic viral hepatitis upon withdrawal.
How Steroids Harm the Liver
The mechanisms by which steroids, especially anabolic-androgenic steroids, can harm the liver involve several pathways. Many oral anabolic steroids are chemically modified (17-alpha-alkylation) to resist liver breakdown. This modification allows higher bloodstream concentrations but strains the liver, causing direct hepatotoxicity, inflammation, and cell damage.
Anabolic steroids can also impair bile flow, resulting in cholestasis, a common form of liver damage. This occurs when the liver’s ability to excrete bile is disrupted, causing a buildup of bile acids and bilirubin. Some anabolic steroids can induce peliosis hepatis, a rare condition forming blood-filled cysts within the liver. These cysts can disrupt normal liver architecture and, in severe cases, lead to rupture and internal bleeding. An unregulated growth stimulus to hepatocytes, or liver cells, is also a likely cause of nodular regeneration and tumor formation linked to anabolic steroid use.
Identifying Liver Concerns
Recognizing signs of liver damage is important for individuals using steroids. Common symptoms include:
Jaundice (yellowing skin or eyes)
Dark urine
Pale stools
Persistent nausea
Vomiting
Fatigue
Abdominal pain (upper right side)
Itching
Liver function tests (LFTs) are a primary diagnostic tool. These blood tests measure enzymes like AST, ALT, alkaline phosphatase, and bilirubin. Elevated levels indicate liver cell damage or impaired bile flow. It is important to note that symptoms may not become apparent until significant liver damage has occurred, emphasizing the importance of timely medical evaluation.
Minimizing Liver Risk
Reducing the risk of liver damage from steroid use involves several important considerations. Medical supervision is a key factor for any steroid administration, as healthcare professionals can monitor liver health and adjust dosages if necessary. Avoiding high doses and prolonged cycles of anabolic steroids is also important, as increased dosage and duration are associated with a higher risk of liver injury.
Oral anabolic steroids, particularly those with 17-alpha-alkylation, are especially noted for their hepatotoxic potential. Combining steroids with other liver-processed substances, like alcohol or certain medications, significantly increases liver damage risk. Avoiding such combinations protects liver health. Regular monitoring of liver function through blood tests is advisable, especially for anabolic steroid users. Approach “liver support supplements” with caution; scientific evidence for their effectiveness in preventing or reversing steroid-induced liver damage is lacking, and they should not replace professional medical advice.