3.1 Effects on muscle tissue

Many studies have focused on the increase of muscle strength and muscle properties. There are other effects as well, an I will try to come in on all of them. The fact is that these other effects will be categorized as side effects, because the purpose of AS is to enhance muscle strength and masculinization , that was why it was made. Side effects are therefore not necessarily negative. AS have effects on a variety of body tissues. The fundamental action is thought to be to an intracellular protein in target tissues. The specific biological mechanisms responsible for changes in strength and muscularity is far from clear, but direct actions on the skeletal muscles is a starting point. From here, two working mechanisms have been found:

1. Testosterone acts directly in muscle tissue. They increase the speed at which new muscle cells are produced/repaired
2. An important part of the musculotrophic effect of Anabolic Steroids may not be directly mediated through Androgen receptors but instead through blocking the Catabolic effect of hormones like cortisol.

Muscular/Anabolic Steroids act on the balance between anabolic and Catabolic processes within the body. Anabolism is the constructive process by which simple substances are transformed to more complex compounds, such as bone and muscle tissue. Catabolism is the opposite destructive process which breaks down these complex compounds for removal from the body. The normal body will attempt to maintain a balance between these two processes as they carry out tissue renewal and replacement. The state of anabolism and Catabolism may be measured by evaluating the body's nitrogen balance. As Stedman's Medical Dictionary puts it; Nitrogen balance is: "- the difference between total nitrogen ingested and the total nitrogen excreted by an organism". In an adult, or a person that is not growing, this should be zero at a given intake or above. Anabolic Steroids reverse the Catabolic effect by increasing protein synthesis in skeletal muscle. They are believed to diffuse into the cellular cytosol and bind to the Androgen receptor. The newly formed receptor-steroid complex travels to the nucleus, interacts with the DNA and starts the transcription. The production of RNA is then increased, causing an increased rate of protein synthesis. In this way, the use of AS increases muscle size and strength. In order for the patient to gain extra muscle mass, his or her body must temporarily be in positive nitrogen balance: More nitrogen (as muscle mass) must come into the body than is lost. During hard exercise, the release of Glucocorticosteroids throws the body into a negative nitrogen balance. After exercise, the body experiences a temporary state of positive nitrogen balance, where new proteins are added to muscle tissue. Unless there is further exercise, the nitrogen balance returns to zero. Without the use of Anabolic Steroids, muscle mass is built up very slowly after long periods of very hard training. Anabolic Steroids can reverse the short-term Catabolic effect, leading to positive nitrogen balance and faster gains in muscle mass. However, maintenance of a positive nitrogen balance is short lived (1 - 2 months) unless the steroid dose is continually increased. Rapid tolerance (tachyphylaxis) to steroids occurs in muscle tissue as the body attempts to maintain homeostasis. One homeostatic mechanism may be a rise in serum Cortisol during steroid treatment. This may decrease the anabolic effect while it increases the catabolic. The risk of serious side effects is increased if the person takes higher and higher doses of anabolics to maintain a positive nitrogen balance. There is some evidence that Anabolic Steroids cause the athlete to feel like working out more often and more vigorously. This psychological effect may be more important than any direct chemical effect. Frequent and more vigorous workouts may be a reason for the increased incidence of connective tissue injuries associated with steroid abuse. The hormones testosterone and Cortisol have a similar molecular shape. Thus, they have the same binding sites in many tissues. When AS are used, the amount of AS in the blood stream is much more abundant than Catabolic steroids like cortisol. The AS will consequently take up a larger amount of the receptor sites. The muscle cells will be packed with hormones that promote growth. So it is a double effect, a combination of 1 and 2 as mentioned earlier. This balance will remain positive until a plateau is reached.

AS, as a class, produce weight gain in normal men. Typical weight gains are 3-5 kg after several weeks of high - dose steroid use. The nature of this weight gain is still uncertain, although an increase in muscle size and total body protein accretion is atleast one reason for the gain. As can be seen from the table 1 on page 7, no study to date has simultaneously studied ALL the changes in the different body compositions in the same study. Since different AS may be quite different in their drug effects, care must be taken in the evaluation of the existing data of different drugs, and dosage. The effects of steroids on strength, are most significant with experienced weightlifters, and when strength training is performed concurrently with the steroid administration. (Ariel G, 1973 Journal of Sports Medicine and Physical Fitness, 13, 187-190) The theoretical explanation behind this is that under normal conditions skeletal muscle anabolic receptor sites are saturated with the natural occurring testosterone levels/molecules. As a result, Anabolic Steroids administration, under normal conditions, has little effect on muscle growth and strength. Exercise increases the number of unsaturated AS receptor sites. This increases the bodies AS processing ability which again increases the effectiveness of AS. AS use, if a desirable goal is increased strength, must therefore be combined with physical exercise. This is also the explanation to why hypogonadal men, and women in general has better effect of AS at lower doses. They have more unsaturated AS receptor sites ( Steve Gallaway, The Steroid Bible, 1997). Still, researchers are not sure whether the increases in strength is primarily due to increased muscle mass, or psychological factors as increased motivation that results in a higher volume of intense training. Since women have 10-15 times less natural testosterone in their body than men, administration of AS are particularly effective for women who want to increase their strength. The following is a summary of the effectiveness of AS administration to athletes. It was originally sent to STASI, march 3, 1977, by the Deputy Director of the program: "...The positive value of Anabolic Steroids for the development of a top performance is undoubted. Here are a few examples. Performances could be improved within four years as follows;"

	Men	Women
Shot -put:	2.5- 4 m	4.5-5 m
Discus throw:	10-12 m	11-20 m
Hammer throw:	6-10 m
Javelin throw:		8-15 m
400 m:		4-5 sec.
1500 m:		7-10 sec.

(Clinical Chemistry, 43, p 1264-1265, 1997)

Anabolic Steroids work by stimulating the anabolic effect discussed earlier by binding or plugging into protein receptors in or on the cells that help create new proteins in the cells. This increased biological activity is called an increase in Ribonucleic Acid Activity (RNA Activity). The construction of new proteins helps increase muscle size and strength. Remember, this normally happens in the body. The steroids stimulate or increase this biological process by binding to the receptor sites on the protein cells.