Clinical Uses of AAS

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TweetClinical Uses

Clearly, hormone replacement therapy is the most common use of testosterone. Anabolic-androgenic steroids (AASs) have many other potential clinical uses.[22] Most of these center on the anabolic nature of these drugs and their use in people with cachexia, produced by such disease states as HIV, hepatic and renal failure, chronic obstructive pulmonary disease (COPD), some types of cancer, and burns, as well as during postoperative recovery. In most clinical scenarios, the association of protein-calorie malnutrition increases the morbidity and mortality of the primary disease state. By preventing this loss of LBM, the clinician can hope to prevent many of the adverse effects caused by the disease and, perhaps, by other treatments that have been enacted. In all clinical cases, with the exception of cancer, AASs have shown efficacy in weight gain.

In HIV infection, testosterone replacement and AAS use are generally considered. Commonly used AASs include oxandrolone, nandrolone, and oxymetholone. All 3 agents have been studied for increased LBM and weight gain.[23, 24, 25, 26]

AASs have been studied in COPD-associated cachexia. Stanozolol (12 mg/d), after an initial 250 mg IM testosterone injection, has been shown to produce significant improvement in a patient's weight, body mass index (BMI), and strength compared with controls at 26 weeks.[27] A study of 217 COPD patients randomized to nandrolone plus nutrition and exercise or to nutrition and exercise alone, for a total of 8 weeks showed that the nandrolone group had significant increases in LBM and maximum inspiratory pressure.[28] Studies of oxandrolone (20 mg/d) also showed significant gains in weight and inspiratory parameters in tetraplegic patients.[29]

Hepatic failure is also associated with protein-calorie malnutrition and wasting. In a study of 273 patients with moderate weight loss due to alcoholic hepatitis, oxandrolone (80 mg/d) improved hepatic function and nutrition parameters and increased 6-month survival when compared with controls.[30] Although this was considered a preliminary study, it showed that the use of AASs, including oral agents, can be useful even in some types of liver failure with associated weight loss.

Wound and burn healing have been treated with AASs, including testosterone esters, stanozolol, oxandrolone, and nandrolone. These agents increase collagen synthesis and the activity of dermal fibroblasts[31] and have a positive effect on healing rates in previously nonhealing wounds.[32]

Cancer-associated cachexia and anemia are very common. AASs have been proposed for use in cancer-associated weight loss and in the treatment of the hypogonadal state that often accompanies severe cachexia. AASs have also been used for their erythropoietic effects, usually in leukemia treatment.

AAS use in renal failure, especially in patients on hemodialysis, has been investigated. A double-blind, placebo-controlled study of 29 dialysis patients receiving either nandrolone (100 mg/wk) or placebo for 6 months showed significant gains in LBM and in functional parameters.[33] Studies also indicate that the erythropoietic effect of AASs (nandrolone decanoate) is useful in chronic renal disease and that when an AAS is used in combination with recombinant human erythropoietin, the gains in hematocrit are greater than when either agent is used alone.[34]

These are just a sample of the many disease states that AASs are used to treat. In most cases in which the anabolic properties of AASs are desired, an increased ingestion of protein and calories must accompany their use. Topics not explored in this article include hormone replacement therapy and the general use of androgenic agents as such. Indeed, in cases such as endometriosis and fibrocystic breast disease, androgens are used clinically to negatively affect the hypothalamic-pituitary-gonadal axis and to limit disease symptoms or progression.

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TweetVery good read, I always knew AAS were benefically for the human body all around, if used properly.