Question 1: How long have steroids been around?

Answer 1: They were originally synthesized in the 1920s and used as the German army was vamping up their aggressive training programs. They pushed higher variations of testosterone into their own soldiers by pumping them up with what was then known as Anabolic-Androgenic Steroids (AAS). Anabolic means to increase and build up proteins within cells, especially in skeletal muscles. Androgenic means more development of masculine characteristics. That’s why you’ve seen the sports industry buzzing about ‘doping, juicing steroids’ abuse especially in the body-building, weight-lifting and speed sports such as swimming, bicycling and track & field. An athlete can work out and the recovery time of muscles is reduced allowing for quicker muscle build up in bigger, faster, stronger ways than previously ever possible.

In fact, there is a documentary called “Bigger, Faster, Stronger.” It is another eye-opener of the sports industry and how profoundly steroid abuse affected so many athletes that were not aware of the long-term effects they would have in their lifetime. From infertility to crippling bone density loss, these athletes expose the dark side of this parallel universe of steroid misuse.

Question 2: When were they first used in sports?

Answer 2:  Since Germany had prompted its use in the early 1930s, it had lots of experience and data on how powerful steroids can be. They continued with state-sponsored athletic training programs with estimates of 10,000 athletes using steroids.  In fact, East Germany stole the world stage of dominating sports in the Olympics for many years during the 1930s-1970s. Unfortunately, the long-term effects of doping were later realized and caused much anguish for those athletes with incalculable physical and mental scars. More tragically, many of them, male and female, did not even know they were being given such powerful drugs, nor did they have any idea of their consequences. 

Question 3: When did they become officially recognized as a medicine?

Answer 3:   The research collaboration of two American doctors from 1930-1938 is where it all started with Dr. E. C. Kendall & Dr. Phillip Hench. They identified the body’s hormone, cortisol, produced by the adrenal glands reduced arthritic symptoms and pain. The second step was realizing another hormone, adrenocorticotropic hormone ACTH, produced by the pituitary gland, worked to stimulate the adrenals to reduce rheumatoid arthritis inflammation.  These two doctors received the Noble Prize Medicine/Physiology in 1950. After seeing the glorification of steroids from the 1930s through the 1950s, there was a race in the medical world to get the hormones synthetically produced in the most cost-efficient way. President Truman even signed an Executive Order to prioritize and test over 5,000 plants to find the closest match! This was our ‘race to the moon’ but in medicine with the urgency to be the first to manufacture and distribute it worldwide!

Question 4: If hydrocortisone is considered dangerous, why is it so easily available over-the-counter with TV commercials touting it for any mysterious itchy, scratchy irritations or rashes, and even for vaginal itch?

Answer 4: Was hoping you’d ask THIS question! This article on MEDPAGE TODAY written by Alicia Ault on March 25, 2005, details how Adrenal Suppression from Topical Corticosteroids Surprisingly High.  That was the day after Dermatologic and Ophthalmic professionals met with the FDA Food & Drug Administration and had a little pow-wow discussing how high the rate of adrenal suppression was in various clinical tests. Surprise!

In 60 children, 58% of them had adrenal suppression after just two weeks of using topical steroids twice per day.  But wait…there’s more! 8 out of 10 adults treated for four weeks also had adrenal suppression. That is more than half. In fact, the FDA has been receiving reports of severe adrenal suppression since 1969!

But in that same meeting of March 2005, the discussion was about moving topical corticosteroids like the lighter version of hydrocortisone, so that it may be more easily available over-the-counter at a higher potency. Despite the FDA rejecting this back in 1957, in 1973 the FDA said topicals in the range of 0.25% to 0.5% were generally recognized as safe, and then later in 1990, the agency increased that up to 1% for drugstore sales. Yet the frequency and availability of topical steroids are increasing worldwide without prescriptions.