QUESTION: I have been taking steroids for several years to help my muscle definition and strength. I know that there are some problems with steroid use by teenagers, but I am an adult and am not worried about bone growth and developmental problems. I really don't compete as a body builder or in weight lifting, but I do work out regularly and like the way I look since beginning their use. I would appreciate your comments.

ANSWER: Anabolic steroids are drugs that resemble male hormones such as testosterone, a natural androgenic hormone that is at least partially responsible for the tremendous developmental changes that occur in young men at puberty. These male hormones have both androgenic and anabolic effects.The androgenic effects are expressed by changes in the primary and secondary sexual characteristics, the anabolic effects by accelerated growth of muscle, bone and red blood cells, and enhanced neural conduction.

The anabolic steroids used by athletes have been manufactured to enhance only the anabolic characteristics and to minimize the androgenic effects. However, non man-made steroids completely eliminate the androgenic effect, and that is one reason there are so many negative side effects relating to sexual characteristics with steroid use.

No one knows exactly how anabolic steroids work to enhance muscular growth, but they probably stimulate genes to activate muscle protein synthesis. They may also affect the enzymes involved in protein metabolism and may even change cell membrane permeability to proteins, allowing more rapid uptake of protein building blocks for the development of muscle. Surprisingly, they don't seem to work well without heavy training, which also triggers increased protein synthesis and muscle growth. An increase in protein intake also seems to be a necessary ingredient for maximum effectiveness.

Should you use anabolic steroids? The answer is a resounding NO! Scientists have accumulated an impressive list of negative side effects that should cause even the most blase to question their worth. This list includes alteration of liver function, changes in cardiovascular function, suppression of the gonadotrophin-testicular axis, and a variety of miscellaneous effects. Athletes using steroids typically show blood enzyme changes associated with liver toxicity, and prolonged use has been linked to severe liver disorders.

One of the most frightening changes in my estimation relates to blood lipid changes. A study in the August 1988 issue of the Physicians and Sports Medicine magazine showed dramatic increases in total cholesterol from a mean of 200 mg/dl to 313 mg/dl after nine months of use. This was accompanied by a large increase in the "bad" LDL cholesterol and a decrease in the "good" HDL cholesterol. Some of the athletes in this study had total cholesterol levels as high as 378 mg/dl. Fortunately, the cholesterol levels went back to near normal when steroids were discontinued.

The effects of steroids on women and young men who are still growing can be devastating because some of the changes are irreversible.