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Coming Off Steroids: What Happens After Stopping Anabolics

Last Updated: January 24, 2022

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Anabolics are either natural or manmade hormones that mimic the male hormone testosterone. Steroids are mostly used by bodybuilders and athletes for improving strength and muscle mass. A very common example is the popular medication prednisone. A recent study indicated that about 32% of steroid users abuse the drugs which can lead to steroid withdrawal syndrome. This syndrome comes with its associated symptoms including extreme fatigue, loss of appetite, and dizziness. Whether someone is taking anabolic steroids illegally or based on a doctor’s orders, coming off steroids can be difficult.

Causes Of Steroid Withdrawal

AAS withdrawal is a real and well-documented phenomenon. The cause of withdrawal is the impact of anabolics on testosterone. AAS drugs do not always contain testosterone, as many believe. However, they do closely mimic the effects of testosterone. This has two effects. One is that the body becomes used to having high levels of testosterone and testosterone-like chemicals. The other is that the body will reduce testosterone production since the drug is taking care of much of what the endocrine system would usually do.

A woman in depression puts her hands over her head.

Steroid Withdrawal Symptoms

Steroid withdrawal symptoms range from common to severe. Some of the common symptoms include headaches and fatigue while the severe symptoms include lowered sex drive. Tapering off steroids like prednisone is not done cold turkey. This is because the adrenal glands need time to resume their normal function. No matter how a person chooses to quit the drugs, the side effects of stopping steroids can be felt. Anyone who is planning to stop AAS drugs needs to be able to recognize the side effects of tapering off and seek help if needed. These signs can be grouped into two – physical and psychological symptoms.

Physical Symptoms of Steroid Withdrawal Include:

  • Headaches
  • Reduced appetite
  • Lowered sex drive
  • Fatigue
  • Joint pain
  • Muscle aches
  • Nausea
  • Vomiting
  • Weakness
  • Decrease in blood pressure
  • Abdominal pain
  • Diarrhea
  • Weight loss

Psychological Symptoms of Steroid Withdrawal Include:

  • Anxiety
  • Depression
  • Struggles concentrating
  • Insomnia
  • Drug cravings

There are other steroid withdrawal symptoms because symptoms can copy other medical conditions. Patients should seek therapy anytime these symptoms rear their heads. When there are manic or psychotic conditions present, medical doctors will prescribe small doses of antimanic and antipsychotic drugs to alleviate the symptoms. Anabolic steroid withdrawal is best managed with the help of an experienced doctor who knows how to mitigate these side effects of anabolics and get the body stabilized as quickly as possible.

What Is Steroid Withdrawal Syndrome?

Steroid withdrawal symptoms occur when the disease being treated returns after undergoing glucocorticoid therapy. It also refers to the conditions where the symptoms of adrenal insufficiency become apparent after reducing or abruptly stopping glucocorticoids. Glucocorticoids are a group of corticosteroids that are strong medicines that help in the treatment of inflammation. They also aid the immune system to fight other diseases. Steroid withdrawal always precedes this syndrome. In a study, prednisone withdrawal or ACTH therapy caused a disease called moderate anorexia.

Timeline for Tapering off Anabolics

There is no guaranteed timeline for coming off anabolics. For some individuals, it may be over in just a few days, while for others, it may linger on for weeks. Also, the type of anabolics medicines and the metabolism of the user can impact withdrawal therapy. Other conditions that can affect therapy include whether or not the user mixed the drugs with alcohol and the user’s medical history. Users of these medications also need to be wary of the route of administration as this can also affect how long it takes to clear the drug in the system.

DAY 1 The first signs of withdrawal emerge but are generally weak in strength.
DAYS 2-6 The severity of the symptoms increases, with mental health effects being particularly strong.
DAYS 5-10 The symptoms start to taper off, but the cravings for anabolic steroids remain high.
DAYS 10-14 The symptoms are mostly gone, with some mental health side effects and cravings still lingering.

Something that users need to consider when coming off AAS is that the withdrawal process may not begin as soon as the drug is stopped. Some AAS drugs remain in the body for weeks, and withdrawal may not be triggered until the AAS drugs in the body get past the half-life point. This means that depending on the drug used or steroids drug interactions, someone may think that they have safely stopped using AAS drugs without withdrawal, only to be caught off guard. Users must research their drug of choice before assuming they are in the clear.

Factors Affecting Withdrawal Duration

As already discovered, the length of withdrawal depends on other factors. This also directly affects the steroid withdrawal symptoms that accompany the period of withdrawal. The longer the tapering off period the more the signs linger.

Here Is a List of Factors That Will Affect How Long It Will Take for the Body to Completely Rid Itself of These Drugs:

  • The frequency with which the user took the anabolics
  • If the user mixed the anabolics with other drugs or alcohol
  • Gender and weight of the user
  • The user’s medical history and mental health
  • The duration of anabolic intake
  • The doses of the anabolic ingestion
  • The route of administration
  • The type of steroids

Anabolics with longer half-lives take more time to taper off. AAS with shorter half-lives does not take long to taper off. Withdrawing from these drugs should be done at a health facility for maximum care and attention. This is because some diseases associated with withdrawal can be discomforting. Also, patients should be wary of using these medicines to prevent future health consequences. Most importantly, people should refrain from abusing anabolics to prevent health complications.

Anabolic Steroids Alternatives As An Option To Quit

Using anabolic steroid alternatives is another way to withdraw from these medications. Several alternatives exist including using human growth hormones (HGH) and a group of drugs called selective androgen receptor modulators (SARMs). Another alternative to steroids is natural steroids made from natural ingredients, which also increase performance and strength and help in gaining muscle. These alternatives to steroids come without or minimum health risks and legal issues associated with anabolic steroids. But consumers should be cautious because abuse of these drugs can lead to health problems. It is advisable to take them under the care of a physician.

SARMs vs Steroids

SARMs or Selective Androgen Receptor Modulators are anabolic steroids alternatives. SARMs are among the best choices for those who want to benefit from an alternative but without harming their health. The difference between SARMs vs steroids is that the first ones selectively bind on a cellular level to the androgen receptors. That is why one can benefit from this anabolic steroids alternative without the horrible risks of steroids, such as gynecomastia, infertility, heart problems, baldness, and others. Thus, comparing the safety of SARMS vs steroids, the former is a safer option.

Unfortunately, many SARMs sold on the online market contain hormones, unapproved substances, and even steroids. Some even have labels with terms and conditions that are completely misleading. If bought on street, all these unapproved ingredients can lead to serious reactions and health issues such as liver disease, heart conditions, aggression, depression disease, and even stroke or thoughts of suicide.

A doctor consults a patient regarding the dangers of steroids withdrawal.

Natural vs Steroids

These terms (natural and steroids) all refer to anabolic steroids. Natural anabolics are derived from plants, herbs, and other natural sources. These hormones mimic the activities of testosterone. They can be used in place of steroids to boost strength and enhance performance. Contrasting the power of natural vs steroids, the natural anabolic strength does not match up to the man-made steroids. However, they are equally effective. Comparing the safety of natural vs steroids, natural anabolics are the best since they are legal and come with little to no health risks. Some of the best natural steroids include creatine, ashwagandha, and Tribulus Terrestris.

Hgh vs Steroids

Human growth hormone (hgh) is a hormone that aids growth, cell regeneration, and production, builds and repairs worn-out tissues. Initially, it was meant to cure dwarfism, but soon it was discovered its use improved muscle gain. Comparing hgh vs steroids, human growth hormone is not recommended for treating low testosterone. Contrasting the efficacy of hgh vs steroids, steroids improve physical appearance by enhancing muscle mass. Hgh can be combined with steroids to witness a marked difference.

Quitting Steroids Safely

No matter why one is taking anabolic steroids, at some point, they will want or need to stop. This could be because the drugs have done their job and/or are no longer needed. After all, the person is experiencing negative effects, or even because steroids show up on drug tests for athletics. No matter the reason for stopping steroids, users need to do it safely.

There Are Two Options a User Might Choose for Quitting the Drugs:

  • Quitting Cold Turkey– is stopping anabolic steroids abruptly. Withdrawal symptoms are experienced severely when stopping cold turkey, and the chances of relapsing are much higher than when using recommended methods for stopping the drugs.
  • Tapering Off Steroids– is the only safe way to stop steroids. This means slowly reducing how much of the drug is taken until the user is no longer taking it at all. Since if the user stops taking AAS drugs all at once, the body is not given a chance to bounce back, and the sudden lack of testosterone can have devastating effects. Tapering, on the other hand, slowly removes the AAS drugs bit by bit, allowing the body to steadily up its testosterone production to replace what the drugs offered. When done correctly, the user may not experience any withdrawal symptoms at all, and if they do, they should be minor

When anabolic steroid use becomes dangerous, it is time to get help. With medical supervision, it is possible to stop anabolic steroid use safely. Whether through an outpatient center or a residential facility, any drug rehab is better than doing nothing. This can be done in an outpatient setting, though some users may feel more secure doing this in an inpatient center or residential facility. The substance abuse treatment will be individualized for the patient to ensure their needs are met. It may last just a few weeks or can go on for over a year, depending on the health of the user.

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Page Sources

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  2. M. Medras, U. Tworowska. (2001). Treatment Strategies of Withdrawal from Long-term of Anabolic-androgenic Steroids. Pol Mekur Lekarski. https://www.ncbi.nlm.nih.gov/pubmed/11899857
  3. JPSM. (2007). The Steroid Withdrawal Syndrome: A Review of The Implications, Etiology, and Treatment. JPSM. https://www.jpsmjournal.com/article/S0885-3924(06)00718-4/fulltext
  4. T. Good, J. Benton, V. Kelly. (n.d.). Symptomatology Resulting from the Withdrawal of Steroid Hormone Therapy. Wiley Online Library. https://onlinelibrary.wiley.com/doi/pdf/10.1002/1529-0131(195908)2:4%3C299::AID-ART1780020403%3E3.0.CO;2-T
  5. J. Gibney, T. Wolthers, G. Johannsson, A. Umpleby, K. Ho. (2005). Growth Hormone and Testosterone Interact Positively to Enhance Protein and Energy Metabolism in Hypopituitary Men. American Journal of Physiology. https://journals.physiology.org/doi/full/10.1152/ajpendo.00483.2004
  6. L. Margolin, D. Cape, R. Bakst-Sisser, J. Greenspan. (2006). The Steroid Withdrawal Syndrome: A Review of the Implications, Etiology, and Treatment. J Pain Symptom Manage. https://pubmed.ncbi.nlm.nih.gov/17280928/

Published on: August 16th, 2019

Updated on: January 24th, 2022

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.