So you feel like a bag of assholes when you roll out of bed? Or your back feels like you’ve been sentenced to the life of Sisyphus? We’ve all been there. So immediately you think let me roll up to the Urgent Care for a “steroid” shot – obviously.
The such sweet sorrow of needle penetrating the sore spot to deliver satiation. You’re American – it doesn’t matter why it “works” in the short term. Ahhhh. Back to the grind – you’re ready.
There’s no wonder it’s appealing. The word steroid is conflated with strength – from Barry Bonds to Arnold Schwarzenegger blasting cyborgs in Greta Thurnburg’s post-apocalyptic world. Who doesn’t want to feel jacked? So with good reason when we’re feeling down, out and hanging by a moment for a miracle, a doctor will offer us a steroid shot and it’s really, really hard to say no.
Well first, should you say no? Make up your own mind – the act of doing something can have positive effects (placebo), and the act of giving it up to God can also have positive effects (lower stress due to personal choices not linked to outcome). Then again, the act of doing anything at the doctor often has deleterious effects. Seriously – look it up.
If you’re a modern day Adonis, you might think this don’t matter to me. I’m never sick. What about your precious IrishDoodle Willoughby? You’re a dog owner…vets are happier than a virgin in a strip club to hand out corticosteroid shots for any and all ailments like ear infections – and charge you for it. And just like in humans, they’re bad for them.
Glucocorticoids, namely cortisol, antagonize insulin function. Such antagonism may cause pancreatic beta cells to secrete more insulin, eventually causing beta cell exhaustion and potential diabetes development. Interestingly, 1 previous study named glucocorticoids “diabetogenic.”2https://www.americanveterinarian.com/journals/amvet/2018/january2018/hyperadrenocorticism-and-diabetes-in-dogs
So what the heck is a steroid shot, in this context, after all? Well it’s technically a Glucorticoid. Breaking down the word sounds a bit like glucose and a bit like steroid. It’s a good name since it’s a type of steroid to increase the amount of glucose (blood sugar) in the blood. ERRMAHGOD blood sugar – relax low carb fool. That’s not why it’s bad for you.
There are other types of steroid hormones. One class is known as mineralocorticoids. Their purpose is to hold on to essential minerals. The most common example being aldosterone going up to retain sodium when you foolishly chug water because every armchair health expert told you to.
And finally the list of steroid hormones that are actually associated with true strength and growth, everyone knows testosterone and its derivative dihydrogentestosterone (DHT) in males. Progesterone is one of the building hormones predominant within women. Estrogen is sometimes considered one as it does drive growth and cell division – and cancer – so that’s legit.
OH MY GOD will you get to the point? Alright less intellectual masturbation, Glucorticoids are associated with tearing down tissue (look up CATABOLIC on interwebz) to create glucose to relieve stress of low blood sugar and temporarily, pain. Imagine that, sugar lowers stress. No wonder we crave tubs of ice cream when you forced to watch shitty rom coms during the holidays. Except for ‘Love Actually’ because that movie is killer.
Are glucorticoids really that mystical term “anti-inflammatory?”
Why are glucorticoids anti-inflammatory? They are immunosuppressive. If you’re sick, does lowering the immune system sound like a great idea? No it’s idiotic On top of that, long term use is associated with causing:
“Osteoporosis, hypertension, dyslipidaemia and insulin resistance/type 2 diabetes mellitus.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047790/
The causing of diabetes is no surprise to many of my followers. Diabetes is a preservation disease brought about by low intake of micronutrients and macronutrients. Starved body leads to alternative fuel sources -> free fatty acids / amino acids circulating -> raises stress -> raises blood sugar through glucorticoids (feels amazing at first) -> slows use of consumed glucose as it is fuel is perceived to be in shortage. It’s more complicated than that as mobilized fatty acids and amino acids also serve to suppress thyroid hormone creation, and to negatively affect the pancreas They are TOXIC to the pancreas – see here. It also should be no surprise that if you’re running through a forest from a lion that if you sprained your ankle your glucorticoids would suppress inflammation in the short term so you can get the f out of there. Recently I dropped a trailer hitch on my foot. It swelled up like crazy but I was able to keep working since the pain was blunted thanks to stress activation. When the stress activation stopped, my foot hurt like hell.
“However, high-dose glucocorticoids are known to induce anorexia when administered to rodents ,  so it is unclear how much of the glucocorticoid-induced changes in muscle protein synthesis are related to reduced food intake. Short-term fasting or energy restriction is known to suppress muscle protein synthesis rates in both rodents and humans , , , . “https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667640/
Holy hell – high glucorticoids suppress appetite and induce anorexia. No freaking surprise there. And the fasting suppresses muscle protein synthesis.
Do they really help heal your injuries? No
When your tissues are already weak, does injecting something that is literally designed to tear down tissue sound like a good idea?
From “Why Zebras Get Ulcers” by Robert M. Sapolsky regarding the degenerative effects of glucorticoids.
Why do salmon die so so soon after spawning? No one is quite sure, but evolutionary biologists with theories… What is known, however, is the proximal mechanism underlying the sudden die-off. It is glucorticoid secretion.If you catch a salmon right after they spawn, just when they are looking a little green around the gills, you find they have huge adrenal glands, peptic ulcers, and kidney lesions; their immune systems have collapsed, they are teeming with parasites and infections. Aha, kind of sounds like Hans Seyle’s rats way back when. Moreover, the salmon have stupendously high glucorticoid concentrations in their bloodstreams. When salmon spawn, regulation of their glucorticoid secretion breaks down. Basically, the brain loses the ability to measure accurately the quantities of circulating hormones and keeps sending a signal to the adrenals to secrete more of them. But is “it” really responsible for their death? Yup, take a salmon right after spawning, remove its adrenals, and it will live for a year afterward…. At least twice in evolutionary history, completely independently, two different sets of species (salmon and Australian marsupial mice) have come up with the identical trick: if you want to degenerate very fast, secrete a ton of glucorticoids.”Robert Sapolsky, Why Zebras Don’t Get Ulcers
With a little rational thought and a little less believing in bullshit diet fads, it makes a lot of sense that in the presence of lower food supply, the body can take muscle or soft tissue to make sugar to keep the brain active which is the most critical of all your organs for survival and replication.
That’s great and all but is there any Pubmed information showing injured tissue gets worse after a steroid injection?
Yes, of course, there is. I wouldn’t lie to you.
…exogenous glucocorticoids have become the most common cause of drug-induced myopathy. Although any commonly used glucocorticoid can cause myopathy, it is implicated more often with the fluorinated glucocorticoid preparations, such as dexamethasone, triamcinolone, and betamethasone. They decrease the rate of protein synthesis leading to muscle atrophy, but the main effect is to induce muscle protein catabolism.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784879/
Complete list of bad shit caused by exogenous glucorticoids
Sometimes speaking in general terms like glucorticoids rise during stress and cause wasting of tissue isn’t good enough.
A rodent model of rapid-onset diabetes induced by glucocorticoids and high-fat feeding
“Thus, a metabolic syndrome or T2DM phenotype can be rapidly induced in young Sprague-Dawley rats by using exogenous Glucorticoids (sic) if a High Fat Diet is consumed. “https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424464/
Based on the aforementioned, Glucorticoids ncrease insulin resistance with the subsequent state of hyperinsulinism.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515447/
Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problemhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503862/
Didn’t actually lower inflammation:
No significant difference in intramuscular soft-tissue inflammation was observed between the control group and the groups receiving MPSS on day 0 or day 2 at any time point. No differences in the area of inflammatory cell infiltrate surrounding the sponge was observed histologically, after sacrificing them, in groups treated with BMP-2.https://www.ncbi.nlm.nih.gov/pubmed/23197010
Soft tissue atrophy (read: less disc in back or joints; worse hair, worse skin)
Soft tissue atrophy and local depigmentation are possible adverse effects of any steroid injection, particularly when given at a superficial site.ps://www.mdedge.com/ccjm/article/95097/drug-therapy/soft-tissue-atrophy-after-corticosteroid-injection
Short-term corticosteroid use is associated with generally mild side effects, including cutaneous effects, electrolyte abnormalities, hypertension, hyperglycemia, pancreatitis, hematologic, immunologic, and neuropsychologic effects, although occasionally, clinically significant side effects may occur. Long-term corticosteroid use may be associated with more serious sequel, including osteoporosis, aseptic joint necrosis, adrenal insufficiency, gastrointestinal, hepatic, and ophthalmologic effects, hyperlipidemia, growth suppression, and possible congenital malformations.https://www.ncbi.nlm.nih.gov/pubmed/11588541
So much winning with those “steroid” shots how can you resist? You’re going to get old and your Glucorticoids will slowly damage your hippocampus to the point where it can no longer manage their levels, and then you’ll rapidly degenerate. Why accelerate that process just to feel better for ten minutes?