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When Does Steroid Treatment Start To Show Its Effect?

Posted on Sat, 3 May 2014

Question: Hi, i had some steroid treatment aged 14 to boost my growth hormone and height. it lasted for 3 months i want to ask about when it started to act to increase GH...from first day of taking, few days, or few weeks?

Answered by Dr. Binu Parameswaran Pillai (5 hours later)

Brief Answer: MAny weeks Detailed Answer: Hi, Good day. I presume that you might have received an anabolic steroid called oxandrolone or another steroid hormone Testosterone at the age of 14 as the treatment lasted for 3 months only. Did you have accelerated growth of facial/pubic and axillary hair at that time? These are given to improve or enhance puberty and it also helps in better release of growth hormone. The maximum height gain is during puberty. The action takes few weeks to start . SO you will notice height gain only after few weeks. Regards Binu

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Binu Parameswaran Pillai (4 days later)

Thank you Dr XXXXXXX for your advice, i have another question relating to internal organs growth and development. Why does high testosterone, in adolescence, lead to growth of our internal organs....yet in adulthood the same high testosterone does not? Best Regards XXXX

Answered by Dr. Binu Parameswaran Pillai (26 minutes later)

Brief Answer: Every organ has a maximum growth potential Detailed Answer: Hello, Good day, A difficult question. It is interesting to know the testosterone dynamics. Testosterone produced in minute quantities during intrauterine life leads to shaping up and growth of a male baby's genitals at birth. A month after birth, testosterone again raises in a male baby similar to the level raised in puberty. This is called XXXXXXX puberty. This lasts up to 6 months after birth. After that, the control mechanisms are tight and significant quantities of Testosterone is not produced until puberty. To answer your question, one thing to remember is that, every organ has a growth potential and once the maximal growth potential of that organ is reached, then it will not grow further. The growth of penis and male sex organs as well vocal cords need combined action of a variety of hormones including growth hormone, Testosterone , Thyroid hormone etc. Imbalance of these affects the growth of these organs. At puberty, a surge of testosterone occurs and growth of organs are enhanced with the help of Thyroid hormone and GH. This will continue for few years and once the maximal growth occurs, then the organ will not grow further. The spine and bones grow to their maximal potential during puberty and there is maximal height gain. Once the bone fuses with the epiphysis ( growing end of bone), then further growth doesn't occur despite having normal amounts of GH and Testosterone. ( However, in a condition called ACROMEGALY, there is unregulated excess growth of GH occurs and organs start growing in unnatural proportions especially hands, feet, face etc). I hope I answered your question now. Regards Binu

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Binu Parameswaran Pillai (41 hours later)

Thank you Dr XXXXXXX for your valued advice. I have one final question. As you know i took some low dose anabolic steroid treatment (oxandrolone) when i was 14 for height boost. My gonadotropins were measured and were in pre-pubertal range. Few months after treatment i had massive pubertal progress..... Was this due to past steriod treatment causing gonadotropins to come into pubertal range? Thanks and Best Regards

Answered by Dr. Binu Parameswaran Pillai (2 days later)

Brief Answer: Yes Detailed Answer: Hi, Sorry for the delay in reply. I was busy with my other professional obligations. Yes, the steroid treatment during puberty has surely kick started your puberty. Often we endocrinologists initiate puberty when gonadotropin secretion is not enough in conditions like CDP ( constitutional delay in puberty). However, this may not always work in all cases of delayed puberty Regards Binu

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Binu Parameswaran Pillai (3 days later)

Thank you Dr XXXXXXX One final query regarding testosterone effects on brain It is thought androgens may cause aggressive behaviour and loss of emotions. Would this be true in male babies since they also have high testosterone in first few months?

Answered by Dr. Binu Parameswaran Pillai (54 minutes later)

Brief Answer: partly yes Detailed Answer: Hi yes. Testosterone androgenize male brain and the way males think. Aggression is partly due to testosterone. However there are other factors like social and family situation etc which modify a child's behaviour. Males prefer adventure and war games. Girls prefer dolls like barbie and less aggressive games. If a female fetus is exposed to too much male hormones in intrauterine life ( like in conditions like congenital adrenal hyperplasia), their brain will be androgenized and they develop some kind of male behaviour. XXXXXXX boys. Some of them develop sexual orientation towards females. This depends on the duration of exposure of brain to androgen. Regards XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Binu Parameswaran Pillai (1 hour later)

Thank you Dr XXXXXXX for your valued answer. You mentioned above testosterone androgenizes the way males think and makes them more aggresive. But this behaviour is only evident later as the baby moves into chilldhood. Or is this behaviour also present in babies? Maybe its present but theyre unable to fully express it since theyre still babies?

Answered by Dr. Binu Parameswaran Pillai (20 hours later)

Brief Answer: True Detailed Answer: You are right. As I mentioned earlier, beginning one month after birth, there is a surge of testosterone until 6 months after birth in male babies. This is called minipuberty. At that time, you can see them having erections. But of course they have no sexual thoughts due to immature brain and they have no nocturnal emissions as the seminiferous tubules have not started to work. As they grow older, the brain matures and the character and behavior is not only determined by male hormones, but also influenced by family, surroundings, friends and society. Regards Binu

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Binu Parameswaran Pillai (2 hours later)

Thank you Dr XXXXXXX For your valued answers. Androgenization of brain early on leads to future male type behaviour without the need for further androgens to be present. This is the point. My question: When is 'male behaviour' reinforced for the first time by circulating androgens in males? Would it be during puberty? In my case im afraid the 'first time' reinforcement was from the steroids treatment i had. Hope you can advise . Wishing you all the best Regards XXXX

Answered by Dr. Binu Parameswaran Pillai (30 hours later)

Brief Answer: N Detailed Answer: Hi, Good day. Without sufficient male hormones, the male child's genitalia will not be well formed during birth. If there is lack of testosterone or if insensitive to testosterone during intrauterine life, a male baby's genitalia will be ambiguous. If you had normal looking genitalia at birth, that means there was enough testosterone during intrauterine life which has androgenized the genitalia as well as the brain. Again as you mentioned, the second peaking of testosterone happens in puberty and there is reinforcement of brain with androgens and we start getting sexual thoughts and attraction towards females. If there is lack or delay of puberty for some reason, we initiate puberty by giving testosterone/oxandralone and then puberty starts. Regards Binu

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Binu Parameswaran Pillai (1 hour later)

Thank you dr XXXXXXX for all your valued answers. From my treatment at 14, it's possible the increase in GH levels was due to newly formed increase in GHRH receptors in pituitary cells. Of course after treatment, number of receptors go back to normal. BUT what is the fate of the newly formed ones ie do they exist in the 'normal' pool of receptors months after stopping the drug? Now at age 32, with oh much confidence can we say all my GHRH receptors have been formed post end of steroid treatment at 14? Thanks and wishing u all the best. Regards

Answered by Dr. Binu Parameswaran Pillai (3 days later)

Brief Answer: Mostl tlikely yes Detailed Answer: Hi, Rather than increase in the number of receptors, the main mehanism is the upregulation of receptors. These reeptors gets internalized in the cells and come to the surface periodically. GHRH gets attached to GHRH receptors in anterior pituitary and secondary to that GH forms. This GH goes and attaches to GH receptors in different cells. This produces IGF-1 ( insulin like growth factor) which is responsible for most of the actions of GH. This means that, if you dont have enough GHRH receptors, GH and IGF-1 are not formed. At this age, if you dont have not enough GH and IGF-1, you feel tired and will develop symptoms of adult GH deficiency. So if you feel well now, you are unlikely to have GH deficicncy ( and have enough GHRH receptors as well). If you still want to confirm that, you may do an IGF-1 level. ( testing GH is difficult and need special tests). But i personally do not feel it is necessary Regards Binu

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Binu Parameswaran Pillai (3 days later)

Thanks Dr XXXXXXX for all your help . Before i close discussion, i would like to know how steroids exert their effect on brain neurotransmitters....is it through binding to the AR receptors, which in turn affect the neurotransmitters. Or by direct action on the neurotransmitters? I'm really anxious to know.....thanks and wishing you all the best Regards

Answered by Dr. Binu Parameswaran Pillai (15 hours later)

Brief Answer: Via AR Detailed Answer: Sex steroid hormones via their action on androgen receptors (AR) regulate neurotransmitters in the male brain to enhance or facilitate sexual behaviour .I am not sure if they have any direct action on neurotransmtter bypassing Androgen receptors. All hormones act through their specific receptors and occasionally cross react with other receptors with structural similarity. Regards Binu

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar