Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

trevorklee.com

Post reply on HN
Print view View original

41–50 of 128 posts

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

#41

Post by fullburley »

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...

That's for one type of muscular dystrophy, SMA, there are many other types without great treatment options. Lifelong exon skipping treatments recently approved for subsets of DMD are >1M USD per year, and result in dystrophin expression at only a few percent of "normal" (see data from trials of casimersin).

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

#42

Post by staticautomatic »

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...

Muscular Dystrophy isn’t a single disease— it’s an umbrella term for a whole class of neurodegenerative diseases with different etiologies. We need to be clear on which one we’re talking about when we talk about cures.

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

#43

Post by skylanh »

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?

There are a number of responses that don't make me comfortable.

The clearest reasoning for why anabolic or androgenic steroids' are NOT given in the context for recovery strength or function in a professional medical setting are that:

- it has unintended consequences that can be severe

- it has unintended consequences that can be long-lasting

- the expected consequences of use are more harmful than the regular recovery

- and that these can be quite harmful, enough that the use of AAS isn't necessary.

and finally the primary goal post surgical:

> One of the most important considerations in selecting operative versus nonoperative treatment is the risk of rerupture. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031433/

Quite a few responses are getting into details of AAS use that isn't quite correct based on my understandings.

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

#44

Post by throwawaylinux »

askvictor wrote: post #27
uptown wrote: post #19

Earlier quoted context omitted.

We’ll, for one it’d ruin sports. If it’s legal and up to the athlete to decide — then in order to remain competitive all athletes would need to take steroids. You’d basically be telling athletes that they’d need to subject their bodies to the side effects of steroids if they wanted to remain competitive in their sport. That seems like an unfair obligation to place on athletes.

I heard an interesting ethical discussion about this; considering natural levels of testosterone vary considerably between humans, couldn't it be considered fairer to allow steroid use provided total levels are below a particular level? It's interesting considering that NSAIDs are used in pretty huge amounts to keep (for example) football players on the field despite injuries, so what you're talking about is already…

You could have the equality league where people's limbs are shaved down to the regulation length too, and they get dosed with just the right amount of alcohol and other things before the game to bring their reaction times and thinking skills down to the level playing field.

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

#45

Post by asdff »

uptown wrote: post #19
symlinkk wrote: post #16

Why are steroids even a controlled drug? If a man wants to use them and knows the risks he should be able to. Same with any drug I guess.

We’ll, for one it’d ruin sports. If it’s legal and up to the athlete to decide — then in order to remain competitive all athletes would need to take steroids. You’d basically be telling athletes that they’d need to subject their bodies to the side effects of steroids if they wanted to remain competitive in their sport. That seems like an unfair obligation to place on athletes.

Every athlete subjects themselves to the side effects of training for their sport. Most careers end with lingering injuries that just would not have happened otherwise.

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

#46

Post by leksak »

dillondoyle wrote: post #34
vimy wrote: post #20

Earlier quoted context omitted.

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/

Climber? I've had three pulley injuries and returned to sport. What, specifically, have you been doing to rehab it?

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

#47

Post by gpt5 »

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...

Interesting. Hopefully the insane price will actually do good by incentivizing more gene therapy innovation.

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

#48

Post by fullburley »

Dylan16807 wrote: post #36
x86_64Ubuntu wrote: post #12

Earlier quoted context omitted.

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.

In the case of DMD, it's a matter of when and which (typically heart), not if. The muscle fibers turn into fiberous tissues that aren't functional muscle. They fail.

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

#49

Post by michaelmrose »

fallingknife wrote: post #24
uptown wrote: post #19

Earlier quoted context omitted.

We’ll, for one it’d ruin sports. If it’s legal and up to the athlete to decide — then in order to remain competitive all athletes would need to take steroids. You’d basically be telling athletes that they’d need to subject their bodies to the side effects of steroids if they wanted to remain competitive in their sport. That seems like an unfair obligation to place on athletes.

Given that pro football players basically have to subject themselves to brain damage I don't think steroids usage is too unfair of a burden.

It doesn't follow that because there is one unfair burden that one person in a broad class that any lesser burden must be tolerated by all members of the class.

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

#50

Post by michaelmrose »

HenryKissinger wrote: post #26
uptown wrote: post #19

Earlier quoted context omitted.

We’ll, for one it’d ruin sports. If it’s legal and up to the athlete to decide — then in order to remain competitive all athletes would need to take steroids. You’d basically be telling athletes that they’d need to subject their bodies to the side effects of steroids if they wanted to remain competitive in their sport. That seems like an unfair obligation to place on athletes.

> We’ll, for one it’d ruin sports. Sports competitions are already rife with athletes on the juice. So it's not like officially authorizing the use of steroids and performance enhancing drugs in competitions would significantly change anything for the worst. One can practice a sport without choosing to enter a competition. The health benefits don't require a medal. > You’d basically be telling athletes that they’d ne…

The entirety of civilization is built on the idea of telling adults what they are allowed to do instead of letting people choose because given all factors because disinterested parties can see that the net result of user freedom would be bad for all involved. I cannot imagine why THIS is the line to be drawn when they benefit to doing so would be so paltry and the cost so clear. Most athletes in most sports aren't using steroids. Post legalization they all would or would be beaten out by someone who is.

> So it's not like officially authorizing the use of steroids and performance enhancing drugs in competitions would significantly change anything for the worst.

Citation needed. Note not a citation that there are many abusers historically but that right now steroid users aren't the minority.

Post reply on HN