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

譯者: Lilian Chiu 審譯者: Helen Chang

They’ve caused global scandals.

它們造成了全球性的醜聞。

They’re banned in most athletic competitions.

大部分的運動競賽中 都禁止使用它們。

But are steroids actually bad for you?

但類固醇真的對你不好嗎？

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

「類固醇」一詞指的是 一個很廣的分子類別，

that share a similar molecular structure,

它們的分子結構類似，

but have many different functions.

但有許多不同的功能。

When people talk about steroids in the context of sports,

在運動的情境中所談到的類固醇

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

指的是類固醇的一個子集合， 類似睪丸素的那些類固醇。

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

雖然在五○年代，精英運動員

及健美選手開始使用這些類固醇，

today, most steroid users are actually not competitive athletes,

但現今大部分的類固醇使用者 其實不是要比賽的運動員，

but people seeking a particular appearance.

而是追求特定外觀的人。

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

這些類固醇有兩個主要效應：

雄性或男性化的效應，

and anabolic, or growth-promoting.

及同化性或促進生長的效應。

These effects mimic naturally-occurring testosterone,

這些效應模仿天然形成的睪丸素，

which drives the development and maintenance

促進男性第二性徵的發展和維護，

of male secondary sex characteristics and general growth in everyone.

以及所有人的一般成長。

That means testosterone and the synthetic steroids based on it

那就表示，睪丸素 和以它為基礎的合成類固醇

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

會促成身體及面部毛髮的生長、

擴大聲帶的面積讓聲音變低沉、

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

增加肌肉質量與力量，

and increased stature and bone mass.

及增加身高與骨頭質量。

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

將類固醇用在娛樂用途的人 追求的是同化、促進生長的效應。

To make muscles grow, steroids first promote protein synthesis—

類固醇讓肌肉長大的方式 是首先促進蛋白質合成——

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

蛋白質是所有細胞、組織、

器官的基礎建材，包括肌肉在內。

including muscles.

Steroids also block cortisol,

類固醇也會阻擋可體松，

a signaling molecule that drives the breakdown of substances

可體松是一種訊號分子， 會造成物質的分解，

including proteins.

包括蛋白質在內。

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

最後，類固醇會促使肌肉 而非脂肪的發展，

and boost our metabolism, shrinking fat deposits.

促進心陳代謝，減少脂肪堆積。

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

這些特性，讓類固醇在治療 許多疾病和損傷上十分珍貴。

They can help people with wasting illnesses,

類固醇能協助慢性消耗性疾病病人， 比如愛滋病和某些癌症，

like AIDS and certain cancers,

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

維持肌肉質量，並協助燒燙傷病人

恢復他們失去的肌肉組織。

So if steroids are used as medicine,

所以，若類固醇可當藥物來使用，

they must be safe to use recreationally, right?

那麼用到娛樂上一定 也很安全，對吧？

Well, it’s not that simple.

嗯，沒那麼簡單。

To create the desired muscle growth,

要創造出期望的肌肉生長，

recreational steroid users must typically take doses orders of magnitude higher

將類固醇用在娛樂用途的人

通常用量遠遠高過醫療處方的用量。

than those prescribed for a medical condition.

Long term, high dose steroid usage can have both undesirable

長期使用高劑量類固醇

會產生不好且直接的傷害——

and outright harmful effects—

some of them dependent on factors like age, sex,

有些依年齡、性別及基本健康狀況等而異。

and underlying health conditions.

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

我們還不確定全部的風險因子有哪些，

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

但能確定將類固醇用在娛樂用途

對青少年的風險特別高。

During puberty, steroid use can prompt bones to mature

在青春期時使用類固醇

可能促使未全長成的骨頭提早成熟，

before they’re done growing, causing growth defects.

導致成長缺陷。

Adolescents are also most at risk

青少年也最有可能因為使用類固醇

for the harmful psychiatric effects of steroid use.

而受到有害的精神面影響。

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

當中最常見的包括

更容易衝動、侵略性增加，

are well-known as “roid rage.”

這就是一般所謂的「類固醇狂怒」。

Up to 60% of users experience these effects.

高達六成的使用者會出現這些效應。

But there are also less common,

但另外還有比較不常見、 比較具傷害力的精神副作用，

more damaging psychiatric side effects like mania and even psychosis.

比如狂躁症及精神病。

Steroid use can damage organs including the liver and kidneys,

使用類固醇有可能會 傷害器官，如肝臟和腎臟，

and cause cardiovascular problems like high blood pressure.

並造成心血管問題，比如高血壓。

While some or all of those effects may be reversible,

雖然這些效應有些 或全部都是可逆的，

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

使用類固醇還會造成肝癌，

尤其是男性。

Though recreational users take steroids for their anabolic effects,

雖然將類固醇用在娛樂用途上 是為了其同化效應，

they also experience androgenic effects— often undesired.

這些使用者仍然會受到雄性效應——

通常不是他們想要的。

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

那可能意味著女性的體毛增加、

and permanent voice deepening in females.

陰蒂變大、聲音永久變低沉。

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

同時，

過量使用類似睪丸素的類固醇， 可能會造成男性的女性化，

because the body converts the excess into estrogen.

因為身體會把過量的部分 轉換成為雌性激素。

This can lead to breast development and shrinking testicles.

這可能會導致乳房發展 以及睪丸縮小。

These effects are not uncommon—

這些效應並不罕見——

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

大約三分之一的男性類固醇用者 會經歷某種程度的這些效應。

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

過量的類固醇也可能讓男性 及女性的繁殖能力下降——

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

因為它會減少精液中的精子 或造成月經沒有來

及其他狀況，如多囊性卵巢綜合症。

like polycystic ovary syndrome.

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

如果停止使用類固醇， 這些效應或許可逆，但不盡然。

The specific steroid, the duration of use,

特定的類固醇種類、使用多久，

and other factors could play a role in reversibility.

及其他因子都可能會影響到可逆性。

Finally, there’s mounting evidence

最後，有越來越多證據顯示，

that users are susceptible to steroid dependence.

使用者會很容易依賴類固醇。

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

他們的耐受性會增加，因此 隨時間所需要的劑量會越來越大。

This increases the risk of harmful effects,

這就會讓有害效應的風險增加，

all of which are increasingly common at higher doses

當劑量越高，使用時間越長，

這些效應就越常見。

taken for longer durations.

Still, there remains little definitive information

然而可靠的資訊極為有限，

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

關於在不同的使用程度上

其傷害有多常見、可逆性有多高。

at different levels of use.

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

我們不夠明白風險因子或暴露程度，

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

還無法肯定地說 把類固醇用在娛樂用途上是無害的。