How do steroids affect your muscles— and the rest of your body? - Anees Bahji

翻译人员: Anqi Zhao 校对人员: Yolanda Zhang

They’ve caused global scandals.

它在国际上恶名远扬，

They’re banned in most athletic competitions.

它被体育赛事所禁止，

But are steroids actually bad for you?

但类固醇真的对你有害吗?

The term “steroids” refers to a broad category of molecules

“类固醇”是一大类分子的统称，

that share a similar molecular structure,

它们结构相似， 却有很多大相径庭的功能。

but have many different functions.

When people talk about steroids in the context of sports,

体育界口中的“类固醇”

they’re referring to a subset of steroids that resemble testosterone.

特指一类与睾酮相似的类固醇。

Though elite athletes and bodybuilders began using these steroids in the 1950s,

虽然顶尖运动员和健美人士

从 20 世纪 50 年代 开始服用类固醇，

today, most steroid users are actually not competitive athletes,

如今，类固醇通常 用于改变身材，

but people seeking a particular appearance.

而非竞技运动。

These steroids have two main effects: androgenic, or masculinizing,

这种类固醇主要有两种效果： 作为雄性激素起效，即雄性化，

and anabolic, or growth-promoting.

以及促进生长的“合成代谢”。

These effects mimic naturally-occurring testosterone,

这些效果与天然睾酮类似，

which drives the development and maintenance

有助于发展并维持男性第二性征，

of male secondary sex characteristics and general growth in everyone.

并对所有人群都有 促进“生长”的作用。

That means testosterone and the synthetic steroids based on it

具体而言，睾酮和 基于睾酮合成的类固醇

promote body and facial hair growth, enlargement of the vocal cords

可以促进体毛、胡须生长， 使声带变宽变厚、声音变低，

and deepening of the voice, increased muscle mass and strength,

增进肌肉质量与力量，

and increased stature and bone mass.

以及增高、带来骨量增长。

Recreational steroid users are after the anabolic, growth promoting effects.

娱乐性类固醇使用者趋之若鹜的是 类固醇的合成代谢，即生长促进功能。

To make muscles grow, steroids first promote protein synthesis—

类固醇增肌第一步： 促进蛋白质合成。

proteins are essential building blocks of all cells, tissues, and organs,

蛋白质是构成所有 细胞、组织、器官的基石，

including muscles.

也是肌肉的基本组成部分。

Steroids also block cortisol,

类固醇还能拮抗皮质醇。

a signaling molecule that drives the breakdown of substances

皮质醇分子会发出指令 促进物质分解，

including proteins.

蛋白质也不例外。

Finally, they may push the development of muscle, rather than fat,

双管齐下，就有可能带来 增肌不增脂的效果，

and boost our metabolism, shrinking fat deposits.

也会增强新陈代谢， 消耗脂肪存储。

These properties make steroids valuable for treating many illnesses and injuries.

类固醇的这些特性使其成为了 治疗很多疾病和损伤的特效药。

They can help people with wasting illnesses,

类固醇可以减少 “消耗性疾病”患者肌肉流失，

like AIDS and certain cancers,

如艾滋病和某些癌症等疾病。

maintain muscle mass and help burn victims recover lost muscle tissue.

也有助于烧伤病人的 肌肉组织再生。

So if steroids are used as medicine,

既然是安全的医疗药品，

they must be safe to use recreationally, right?

娱乐性使用类固醇 也一定安全吧？

Well, it’s not that simple.

事情并没有那么简单。

To create the desired muscle growth,

增肌所需的剂量极高，

recreational steroid users must typically take doses orders of magnitude higher

娱乐性使用者通常必须服用

高于普通医疗用药 若干数量级的类固醇。

than those prescribed for a medical condition.

Long term, high dose steroid usage can have both undesirable

长期、高剂量使用类固醇

会带来令人不快， 甚至有害的副作用——

and outright harmful effects—

some of them dependent on factors like age, sex,

有些副作用与使用者的

年龄、性别、健康等状况相关。

and underlying health conditions.

We’re not sure what all the risk factors are,

全部的风险因素尚不明确，

but we do know recreational steroid use is particularly risky for adolescents.

但已知青少年爱好者 使用类固醇会尤为危险。

During puberty, steroid use can prompt bones to mature

类固醇会使青春期 尚未停止生长的骨骼过早成熟，

before they’re done growing, causing growth defects.

造成发育缺陷。

Adolescents are also most at risk

精神方面，类固醇对青少年

for the harmful psychiatric effects of steroid use.

同样有更大的影响，

The most common of these, increased impulsivity and increased aggression,

最常见的是变得冲动、 更具有攻击性，

are well-known as “roid rage.”

即臭名昭著的 “固醇暴怒”（“roid rage”）。

Up to 60% of users experience these effects.

高达六成的使用者 都会出现这些副作用。

But there are also less common,

还有其他相对少见， 但更严重的精神异常，

more damaging psychiatric side effects like mania and even psychosis.

如躁狂、甚至精神错乱。

Steroid use can damage organs including the liver and kidneys,

类固醇会造成肝、肾等器官的损伤，

and cause cardiovascular problems like high blood pressure.

也会引起高血压等心血管问题。

While some or all of those effects may be reversible,

虽然以上大部分副作用 或许是可以逆转的，

steroid use can also cause liver cancer, especially in males.

但类固醇也会引起肝癌， 特别是对男性而言。

Though recreational users take steroids for their anabolic effects,

尽管爱好者用药是出于 类固醇“促进生长”的功能，

they also experience androgenic effects— often undesired.

但类固醇的“雄性化”作用 也常常不请自来。

That can mean increased body hair, enlargement of the clitoris,

这往往导致女性 体毛增多，阴蒂变大，

and permanent voice deepening in females.

以及永久性的声音变化。

At the same time, excess testosterone-like steroids can cause feminization in males,

同时，过多类似睾酮的类固醇 会在体内被转化为雌激素，

because the body converts the excess into estrogen.

令男性女性化，

This can lead to breast development and shrinking testicles.

可导致胸部发育、睾丸缩小。

These effects are not uncommon—

这些副作用并不罕见：

about a third of male steroid users experience them to some degree.

约三分之一男性使用者 都或多或少经历过。

Excess steroid use can also reduce fertility in males and females—

过度使用类固醇 会导致男女生殖功能减退，

by reducing the sperm in semen or by causing missed periods and conditions

如精液中精子量减少，

月经暂停，以及 多囊卵巢综合征等异常。

like polycystic ovary syndrome.

All these effects may be reversible if steroid use stops— but they may not be.

停用类固醇可能逆转上述症状， 但不是所有人都能迷途知返。

The specific steroid, the duration of use,

能否复原取决于

and other factors could play a role in reversibility.

所服用的类固醇、 服用时长等因素。

Finally, there’s mounting evidence

最后，越来越多的证据表明，

that users are susceptible to steroid dependence.

类固醇能导致药物依赖。

They can develop tolerance and require increasingly large doses over time.

使用者可以产生耐药性， 所需剂量会越来越高。

This increases the risk of harmful effects,

这也令类固醇的 使用风险显著增高：

all of which are increasingly common at higher doses

剂量越高，使用时间越久，

taken for longer durations.

副作用就越常见。

Still, there remains little definitive information

尽管如此，我们依旧 缺乏更确切的资料，

on how common and how reversible almost any of the harms are

去判断每一种副作用 在各个程度的使用者中

at different levels of use.

有多常见，以及是否可逆。

We don’t know enough, about either risk factors or exposure levels,

目前，我们对类固醇使用 及其风险因素依然了解不足，

to definitively say any recreational steroid use will be harm-free.

无法提供绝对安全的 娱乐性用药方案。