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Steroids, Sterols, Anabolic Steroids, and Corticosteroids: What's the Difference?

Steroids are important compounds used in medicine, but people often misunderstand what they are.

The term steroid and sterol simply refer to chemical molecules that share a common chemical ring structure. There are many steroids and sterols that are important in health and medicine. Some may be used as medications. Some steroids are called hormones. Hormones are chemicals that are made in the brain, kidneys, or sex organs. They carry a signal to other cells in the body to change the way that part of the body is working. Other steroids are not hormones and have a direct action on their own.

The adrenal glands in your body make several types of steroids. Each has a specific purpose. Steroids are also found in other animals, and in plants. For example, the drug digitalis comes from the foxglove plant. It was 1 of the first steroids used in medicine.

Your body makes these types of steroids:

  • Sex hormones. These are the male hormones, including testosterone, which together are called androgens, and the female hormones, including estradiol, a type of estrogen. Anabolic steroids are another name for androgens.

  • Corticosteroids. These hormones include cortisone and cortisol. They are thought to have a role in the immune system.

  • Mineralocorticoids. These hormones maintain the balance of sodium and potassium in the body and include aldosterone.

  • Bile salts or bile acid. These steroids are made in the liver. They don't function as hormones, but are necessary for digestion and absorption of fats.

  • Sterols. The most commonly known of these is cholesterol. Other sterols help your body to make vitamin D from sunlight and to build cell walls.

Commercially produced corticosteroids are steroids that reduce inflammation. They include hydrocortisone, prednisone, dexamethasone, triamcinolone, budesonide, betamethasone, fluticasone, and flunisolide. The FDA has approved more than 100 corticosteroids for patient use. They are used in pills, ointments, inhalers, and by injection to treat diseases that cause inflammation, including multiple sclerosis, lupus, rheumatoid arthritis, and other autoimmune diseases. They also are used to treat many skin conditions, and leukemia and other cancers.

Corticosteroids are very important in the treatment of asthma and COPD. They help to reduce inflammation in the lungs' airways. A health care provider can prescribe them in various forms. Most people use the inhaled form because it has fewer side effects.

Rarely people experience side effects, like thrush after using inhaled steroids. But, cleansing the mouth with water after use can reduce this oral yeast infection. When taken over a long period of time, oral corticosteroids also can have side effects, like weight gain, ulcers, high blood glucose and cataracts. But, when taking the recommended dosage under a health care provider's supervision, they are considered safe.

Anabolic steroids are male hormones like testosterone or commercially produced chemicals identical to male hormones. When produced naturally by the body, they increase muscle mass and direct proteins to make muscle. As men age, their testosterone production may decrease resulting in mood changes or loss of bone density. Testosterone is sometimes prescribed to treat low testosterone levels. Anabolic steroids are also commonly taken and abused by athletes to boost athletic performance and build muscle mass. Some teenagers abuse them, too.

Taking doses of anabolic steroids beyond the body's normal level increases the risk for prostate cancer, stroke, and heart attack. People who take unnecessary doses of anabolic steroids may display violent behavior and drastic mood swings. They may also suffer from depression. Unfortunately, they can cause lasting damage, according to the National Institute on Drug Abuse.