Essentially, what is the difference between an anabolic steroid, and a ‘regular’ steroid, like inhalers for asthma? Are the side effects for using an inhaler the same as using anabolic steroids? Or is it that the steroids in inhalers are present in small quantities, and therefore not noticeable in daily activities?
This question made me realize that, although I have referred in many postings to “steroids” or “cortisone-type steroids,” I have never really defined the term, and have not distinguished between the many different hormones and other biological chemicals which are steroids.
The word steroid refers to the many biological chemicals which have a complex ring structure. Included within the definition of steroids would be cortisone and its derivatives, estrogen in its various types, progesterone, testosterone and other androgenic (male type) hormones related to it, as well as bile acids produced by the liver, and good old cholesterol. In fact, cholesterol is the starting point for the synthesis of many of these hormones, and therefore is quite necessary, in reasonable quantities, for our normal life.
Steroid hormones are synthesized in distinct endocrine glands. Endocrine means that the gland secretes its product into the blood stream, which carries it to the other organs or cells which it influences. Generally speaking, cortisone and its related hormones are synthesized in the adrenal cortex, estrogen and progesterone are synthesized in the ovaries, and testosterone and its related hormones are synthesized in the testes. However, there are overlaps and variations — women normally synthesize some testosterone in both their adrenal glands and their ovaries, and this continues even after menopause, although in reduced quantities. Some tumors of the testes secrete estrogens, and can cause a man to become feminized, with breast enlargement and loss of facial hair. Tumors of the adrenal gland can secrete androgens, the male hormones, and if present in a woman will cause her to become masculinized. Some ovarian tumors can also do this.
In medical speech, the term steroid has evolved to mean a steroid hormone of the cortisone type. When we want to refer to testosterone or estrogen, we will generally use those specific terms, not the more general term steroid, even though those hormones are, strictly speaking, steroids. Many cortisone-type drugs, which have powerful anti-inflammatory effects, have been synthesized, and are used in creams, pills, inhalers such as you refer to, and nasal sprays, as well as by injection. Prednisone, which is such a synthetic steroid, is the one most commonly used in pill form for a wide variety of diseases, including asthma, the autoimmune diseases, and many allergic reactions. Variations in the steroid molecule to make the hormones more potent have resulted in a bewildering variety of creams and ointments for skin conditions. Hydrocortisone cream, which is available over the counter without a prescription for the treatment of minor skin conditions, is one of the weaker variations.
Anabolic steroids, which are now infamous mostly for their abuse by athletes, are mostly testosterone variations in which the molecule has been manipulated to increase the anabolic properties, those that lead to tissue growth and strength, while at the same time reducing the androgenic properties which produce masculinization. This separation can rarely be complete though, and female athletes who have abused anabolic steroids risk significant masculinization. Whether anabolic steroids really increase muscle mass and strength is still debated among pharmacologists who study such things, although I gather there is no such debate among athletes and coaches. The extent to which taking such drugs is harmful is also much debated. Unfortunately, in the prevailing emotional climate I suspect good research to identify the benefits and dangers of these drugs will not be possible. Since anabolic hormones have the distinct steroid nucleus, they can be rather easily detected through blood or urine tests, which are now routine at all major athletic competitions.
In summary, the steroid in your asthma inhaler, which is certainly a cortisone-type steroid, will have minimal anabolic properties. The steroid molecule has been manipulated to maximize its anti-inflammatory effects. In contrast, Deca-Durabolin, a powerful anabolic steroid, will have no beneficial effect against asthma or any of the conditions requiring an anti-inflammatory effect. All of the anabolic steroids are now strongly controlled because of their abuse potential.