"Corticosteroids And Youth"


Corticosteroids are potent drugs used in management of various inflammatory and autoimmune disorders. The anti-inflammatory effects of corticosteroids cannot however be separated from their metabolic effects. Children are more vulnerable to their side effects, particularly the effects on growth, immunity and adrenal suppression. It is essential for the treating physician to be aware of the side effects and the measures to be taken to minimize them. A side effect that is unique to children is growth suppression.


A: Inhaled corticosteroids (this is the full name for these medications) revolutionized the treatment of asthma when they were introduced about 30 years ago. Prior to that, people with asthma had to take corticosteroids by mouth or injection for severe attacks and just try to manage with short-acting symptom relievers in between. Because only a small amount of the steroids that were taken by mouth or injected reached the lungs, the doses required were much higher (sometimes tenfold or more). Growth was clearly stunted by the heavy use of oral corticosteroids.


10. Stunted Growth (height)

The use of some steroids can possibly stunt the growth potential of people who have not finished growing. This is only possible with certain steroids, and not with others. In fact, certain steroids have been used in clinical settings to improve growth rates in children. It is probable that the premature closure of the epiphysial cartilage, which is most likely caused

By aromatizable steroids, will lead to a possible growth inhibiting effect, and could ultimately result in a shorter adult height. This most likely an irreversible side effect, as the growth plates would have sealed and can not "re-open". Anavar (Oxandrolone) has been used to improve the height of growth stunted children, and it is probable that most DHT-derived steroids could also be used for this purpose as could certain anti-estrogens.

Speaking in broad terms, growth stops at the end of the teenage years...there is almost no chance to keep growing.

This is because lengthening of a bone occurs at the epiphyseal growth plates (called the "growth plates" in common parlance), the remnant of the cartilage model. It's capable of proliferating. In 99.9% of humans, the process of bone elongation ends at around the mid to late teen years. At this point, the growth plates are obliterated and disappear, after which no more elongation (typified by an increase in limb length, height, etc...) can take place. Elongation of the bone occurs here and at a second epiphysis at the end. The proliferation of the cartilage happens very quickly, actually fast enough to keep ahead of the bone generation that's "chasing" it, called ossification, which is just the replacement of cartilage by bone. As long as the cartilage growth "stays ahead" of the bone, you grow taller, as bone replaces cartilage. When the bone finally catches the cartilage (because the cartilage slows its growth rate, not the bone), it ossifies, and "seals" the growth plate.

Here's a growth plate picture, enhanced by radioactive dye (GP= Growth Plate), so you can sort of see the bone "catching" up with the cartilage.



Teenagers and young adults who take steroids can have even more serious steroids side effects. For example, teenagers  who take steroids can end up not growing as tall as they would naturally because the steroids can close down the growth of bones.


For adolescents—stunted growth due to premature skeletal maturation and accelerated puberty changes; risk of not reaching expected height if AAS is taken before the typical adolescent growth spurt.


Growth retardation is a side effect that occurs especially with long-term, systemic (oral or injected) administration of GCS before age two or at puberty. Experts say that children usually resume growing once GCS therapy is discontinued.


Growth retardation is a side effect that occurs especially with long-term, systemic (oral or injected) administration of GCS before age two or at puberty. Experts say that children usually resume growing once GCS therapy is discontinued.


Younger Users

It should be noted that children and adolescents who use steroids can suffer irreparable physical damage as these are the most pivotal years for bodily growth. Adolescent growth can be prematurely slowed or even stopped due to accelerated skeletal and muscular development due to the increased amount of hormones in the body.


If someone takes them a long time, it can also negatively affect the eyes, heart, growth, bones, and ability to fight infection.


Special dangers to adolescents

Anabolic steroids can halt growth prematurely in adolescents. "What happens is that steroids close the growth centers in a kid's bones", says Dr. Wadler. "Once these growth plates are closed, they cannot reopen so adolescents that take too many steroids may end up shorter than they should have been."



Rising levels of testosterone and other sex hormones normally trigger the growth spurt that occurs during puberty and adolescence. Subsequently, when these hormones reach certain levels, they signal the bones to stop growing, locking a person into his or her maximum height.


Stunted Growth

Studies have shown that adolescents who abuse steroids are at risk of being short for life. Because the body responds to puberty by slowing and eventually stopping growth, the pubescent period of life is crucial to future development. When the adolescent brain senses a certain level of hormones in the body, it will send messages to the bones to stop growing, closing the growth plates in the long bones. Young male abusers can expect to be permanently shorter than average height.


It's been found that if steroids are used in young athletes, whether they are involved in body building or any sport, that the steroids will limit final body height because steroids cause an early end to bone growth.


What Other Adverse Effects Do AAS Have on Health?

Steroid abuse can lead to serious, even irreversible health problems. Some of the most dangerous among these include liver damage; jaundice (yellowish pigmentation of skin, tissues, and body fluids); fluid retention; high blood pressure; increases in LDL (“bad” cholesterol); and decreases in HDL (“good” cholesterol). Other reported effects include renal failure, severe acne, and trembling. In addition, there are some gender- and age-specific adverse effects:

For men—shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer

For women—growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice

For adolescents—stunted growth due to premature skeletal maturation and accelerated puberty changes; risk of not reaching expected height if AAS is taken before the typical adolescent growth spurt

In addition, people who inject AAS run the added risk of contracting or transmitting HIV/AIDS or hepatitis, which causes serious damage to the liver.


One of the main reasons why teens and steroids don’t mix, however, is that the use of anabolic steroids in teens can affect growth. Teenagers, especially male teenagers, are not yet fully grown. Their body is programmed to continue growing until the levels of testosterone in the body reach a certain level.


For adolescents--growth halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.



Teens and Steroid Use

Teens can face further side effects from steroids including the permanent stunting of growth. The use of anabolic steroids by teens in pursuit of muscle can only be characterized by immaturity and stupidity. Even the most ardent of steroid supporters will typically vehemently advise against steroid use before a person reaches their mid-twenties and the natural growth process has been fully completed.


Side effects of systemic steroids tend to occur after months or years of use and include: acne, weight gain, mood or behavior changes, upset stomach, bone loss, eye changes, and slowing of growth. These side effects rarely occur with short-term use, such as for an acute asthma attack.

Isn't the goal to get kids off steroid medications at some point?

No, says Boas. In fact, studies are showing that even those with mild asthma suffer damaging changes in lung tissues and cells (called airway remodeling). The changes seem to lead to persistent, harder-to-control asthma, he tells WebMD. Regular use of asthma medication has been shown to reverse those changes, he says.

"We can't just be giving a child medication depending on how he feels today," Boas tells WebMD. "If a child has persistent asthma, we need to be giving him steroid medications on a daily basis."


Adolescents may experience a permanent halt to the growth cycle and also a dependency upon the drug.

Cortisone is a hormone produced by the adrenal gland and is essential to properly metabolize fat, protein and carbohydrates. It is also instrumental in kidney function and resistance to disease. Synthetic forms of cortisone can be used to treat adrenal insufficiency, rheumatoid arthritis, rheumatic fever and other inflammatory diseases


The side effects of steroids depend on the extent of their use and the user’s preexisting physical condition. With extended use, they are always dangerous and can cause a number of extreme, long-lasting and sometimes irreversible health problems. The side effects of steroids include stunting of growth in adolescents, the appearance of masculine physical characteristics in women and of feminine ones in men, unfavorable change in sexual characteristics in both genders and psychiatric complications.


Side effects of inhaled corticosteroids

When using inhaled corticosteroids, some of the drug may deposit in your mouth and throat instead of making it to your lungs. This can cause:

If you gargle and rinse your mouth with water — don't swallow — after each puff on your corticosteroid inhaler, you may be able to avoid mouth and throat irritation. Although some researchers have speculated that inhaled


• For adolescents—stunted growth due to premature skeletal maturation and accelerated puberty changes; adolescents risk not reaching their expected height if they take AAS before the typical adolescent growth spurt.

Web MD Link: http://www.webmd.com/asthma/news/20010613/what-you-should-know-when-kids-have-asthma

"Some might even argue that not giving medication would impact long-term growth -- that it would impact the child's overall health," he says. "Chronic asthma is associated with poorer growth."


Effects of androgens in humans are:

    1. Skeletal growth and maturation

    2. Effect of bone resorption and bone formation

    3. Effect on serum calcium, phosphorus, and alkaline phosphates

    4. Effect of testosterone on calcium and phosphorus balances

    5. Effect of other synthetic anabolic agents on calcium and phosphorus balance


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