Reversibility of the effects on blood cells, lipids, liver function and hormones in former anabolic-androgenic steroid abusers

Background: In contrast to the acute effects of anabolic-androgenic steroid (AAS) abuse, the long-term risk profile of former long-term abusers (ExA) is less clear. Methods: Blood parameters of 32 male bodybuilders and powerlifters were studied. Fifteen ExA had not been abusing AAS for at least 12-43 months on average (mean dosage 700 mg for 26 weeks per year over 9 years), 17 athletes (A) were still abusing AAS (750 mg for 33 weeks per 8 years). Findings: Hemoglobin (+5%), leucocytes (+33%) and platelets (+38%) were significantly higher in A. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher, cholinesterase activity (CHE) lower in A (65 +/- 55, 38 +/- 27 and 3719 +/- 1528 U/I) compared to ExA (24 +/- 10, 18 +/- 11 and 6345 +/- 975 U/I; each P < 0.001) with normal values for gamma-glutamyl transpeptidase (gamma-GT) and bilirubin. ALT, AST and CHE correlated significantly with the extent (duration and weekly dosage, expressed as a point score) of AAS abuse in A (r = 0.68, 0.57 and -0.62; each P < 0.01). Total and LDL-cholesterol were similar, HDL-cholesterol was distinctly lower in A than in ExA (17 +/- 11 and 43 +/- 11 mg/dl; P < 0.001) and correlated negatively with the extent of AAS abuse (r = -0.50; P < 0.05). Testosterone and estradiol were significantly higher, while LH, FSH and the sexual-hormone-binding (SHB) protein were lower in A than in ExA (each P < 0.001). Two ExA had testosterone levels below the normal range. Interpretation: The alterations in cell counts, HDL-cholesterol, liver function and most hormones of the pituitary-testicular axis induced by a long-term abuse of AAS were reversible after stopping the medication for over I year. In some ExA, an increased ALT activity and a depressed testosterone synthesis were found. (C) 2003 Published by Elsevier Science Ltd.