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Why can't we just give steroids to people with muscular dystrophy?

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Re: Why can't we just give steroids to people with muscular dystrophy?

#31

Post by ggreer »

wisty wrote: post #22
gruez wrote: post #18

Earlier quoted context omitted.

>As a result, when you end your cycle, your body needs to restart its natural test production. There can be a delay while this happens and it leads to unpleasant, though temporary, side effects, like weight gain and a loss of sexual appetite. Why not just slowly taper it off?

Test is injected into muscles, usually once every 2-4 weeks. It can't be taken orally. This makes dosage control difficult. The long half-life also means that your body's control systems are slow to act (if they reacted quickly then you'd risk ending up with too much, and be unable to get rid of it).

There are plenty of other anabolic steroids. Some are oral, and many have the same primary effect with fewer side effects. There's even a new class of drugs that can work for women.[1]

1. https://en.wikipedia.org/wiki/Selective_androgen_receptor_mo...

Re: Why can't we just give steroids to people with muscular dystrophy?

#32

Post by matheusmoreira »

nikita wrote: post #2

A different question. As someone who had to recover from Achilles tear and had to rebuild an atrophied calf muscle. Why don’t we just give anabolic steroids to people if their muscles atrophied after wearing a cast?

Anabolic steroids must be administered very carefully because they are part of a neuroendocrine feedback system.

https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary...

The hypothalamus releases GnRH which tells the hypophysis to stimulate the testicles. The hypophysis releases LH which tells the testicles to release testosterone.

If there's too much testosterone, the GnRH release of the hypothalamus is inhibited. If there's too little, it is stimulated. Through this mechanism, testosterone levels are regulated.

Introducing exogenous testosterone can seriously screw with this system. The extra testosterone causes negative feedback on GnRH and LH, decreasing or stopping natural testosterone production: hypogonadism.

Physical therapy does not have these risks and is effective at recovering functionality. Perhaps a specialist would use anabolic steroids in case physical therapy alone isn't enough.

Re: Why can't we just give steroids to people with muscular dystrophy?

#34

Post by dillondoyle »

vimy wrote: post #20
nikita wrote: post #2

A different question. As someone who had to recover from Achilles tear and had to rebuild an atrophied calf muscle. Why don’t we just give anabolic steroids to people if their muscles atrophied after wearing a cast?

Or BPC 157.

Has anyone here used it? Or TB-500?

I have a tendon/pulley injury that doesn't seem to want to heal and I've been researching it. At least one relevant study.

There is one Dr. in my area (a gyno of all things) that has a website promoting his practice using it. So has at least a sheen of professionalism.

https://pubmed.ncbi.nlm.nih.gov/21030672/

Re: Why can't we just give steroids to people with muscular dystrophy?

#35

Post by krrrh »

cgh wrote: post #9
nikita wrote: post #2

A different question. As someone who had to recover from Achilles tear and had to rebuild an atrophied calf muscle. Why don’t we just give anabolic steroids to people if their muscles atrophied after wearing a cast?

In men, there are complications with your body’s natural testosterone production. If you inject test (the most basic anabolic steroid) then in order to maintain a sort of homeostasis, your body will lower its natural test production. The same goes for any other anabolic steroid, as they are all test derivatives. As a result, when you end your cycle, your body needs to restart its natural test production. There can be…

What you’re saying is true for long term abuse of steroids, but a modest one month cycle of deca for recovery from surgery will not result in any of these side effects in the vast majority of cases. Sensible tapering would make them even less likely.

As others in this thread have pointed out it’s not necessarily a good approach for healing a tendon, and could be counterproductive.

Back in the day when designer “pro-steroids” (basically tweaked pro-hormones that metabolized into anabolic steroids in the body) were widely and legally available from supplement manufacturers, I had a bone graft surgery scheduled and wrote to the chemist who had developed one of the better products to get advice on a cycle for my recovery. This is anecdotal of course, but my surgeon told me that when she was fixing up the bone she realized it was in worse shape than the MRI had indicated and she puts the odds of success at 50/50. She was amazed at the speed and completeness of my recovery. I still have Frankenstein scars where the stitches were because my skin had “healed so quickly” that the stitches were difficult to remove and left gnarly holes.

I like to think that the supplement tipped the odds in my favour. Despite the well-established benefits of anabolic steroids on bone healing, the stigma around them means they are almost never prescribed even in bad cases. YMMV, but other than a few friends commenting that I a bit of an asshole while on the cycle (which could have just been the misery of post-surgery), I suffered no ill after-effects and actually put on a few pounds of lean mass despite being largely convalescent.

Re: Why can't we just give steroids to people with muscular dystrophy?

#36

Post by Dylan16807 »

x86_64Ubuntu wrote: post #12
Dylan16807 wrote: post #10

I don't really understand. Clearly the muscles work to some extent, so isn't making more a lot better than doing nothing? > It’d be like if you had a construction project, and you found out that all of the wooden beams you were receiving from a supplier were rotten. Would you order more beams from that same supplier to fix the problem? If my other option is shrugging and doing nothing and being sad as the house falls…

The beam analogy doesn't work because the rotted wood can provide some support. But the author states that the muscle just dies due a defect. So it's more akin to having tires that develop bubbles in the first 50 miles. Giving you more tires isn't going to help because that means you will spend more time changing them out over and over again.

The muscle fibers are likely to fail but they still have muscles.

Re: Why can't we just give steroids to people with muscular dystrophy?

#37

Post by klevertree »

Dylan16807 wrote: post #10

I don't really understand. Clearly the muscles work to some extent, so isn't making more a lot better than doing nothing? > It’d be like if you had a construction project, and you found out that all of the wooden beams you were receiving from a supplier were rotten. Would you order more beams from that same supplier to fix the problem? If my other option is shrugging and doing nothing and being sad as the house falls…

In this analogy, I meant to indicate all the wooden beams were rotten to the core, in the same way that muscles die in Duchenne muscular dystrophy. Quadrupling up the beams just means that you've spent a lot more resources on something that's fundamentally unusable.

Re: Why can't we just give steroids to people with muscular dystrophy?

#38

Post by klevertree »

BadCookie wrote: post #28
Dylan16807 wrote: post #10

I don't really understand. Clearly the muscles work to some extent, so isn't making more a lot better than doing nothing? > It’d be like if you had a construction project, and you found out that all of the wooden beams you were receiving from a supplier were rotten. Would you order more beams from that same supplier to fix the problem? If my other option is shrugging and doing nothing and being sad as the house falls…

I don’t think the author of the linked article understands either. Why is it obvious that myostatin inhibitors would ameliorate muscular dystrophy in mice but not humans? Nothing in this essay answers that question. Some people with certain types of muscular dystrophy spend years or even decades at near-normal muscle strength, so if you could return them to their previous muscle mass somehow, presumably it would do s…

Sorry, didn't mean that it was obvious scientifically. I meant obvious in terms of pharmaceutical progress. They built a mouse model to mimic muscular dystrophy and cured the mouse model of muscular dystrophy, which is why they felt confident spending their millions on human muscular dystrophy. Unfortunately, it was not a good model, in the same way that most most mouse models are not good models.

Re: Why can't we just give steroids to people with muscular dystrophy?

#39

Post by klevertree »

gzer0 wrote: post #29
Fezzik wrote: post #6

Interesting close-to-the-end note related to much of the medical research (on mice) that gets posted to HN: “The end result, in retrospect, was predictable: they successfully cured muscular dystrophy in mice, but not in humans.”

A cure for muscular dystrophy for humans already exists. Only problem is, it costs a whopping $2 million USD. [1] https://www.reuters.com/article/us-novartis-genetherapy/nova... [2] https://www.npr.org/sections/health-shots/2019/05/24/7254041...

That's not muscular dystrophy. That's a motor neuron disease.

Re: Why can't we just give steroids to people with muscular dystrophy?

#40

Post by Dylan16807 »

gzer0 wrote: post #33

A cure for muscular dystrophy for humans already exists. Only problem is, it costs a whopping $2 million USD. [1] https://www.reuters.com/article/us-novartis-genetherapy/nova... [2] https://www.npr.org/sections/health-shots/2019/05/24/7254041...

Also you can only use it on babies.

But as pointed out elsewhere, wrong disease.

As for that drug, I doubt the price would need to be that high if people were ordering a thousand doses a year, but I'm no expert.

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