Is Testosterone a Steroid? Understanding the Facts and Misconceptions

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Reviewed by
Anneliese Cadena
AGNP-C

Board-certified Nurse Practitioner helping midlife adults optimize performance with personalized care: hormones, nutrition, sleep, fitness, sex.

Testosterone plays a central role as a key male sex hormone, influencing the development of male physical traits and reproductive function. It helps increase muscle mass, stimulates facial and body hair growth, deepens the voice during puberty, and regulates libido. It also supports red blood cell production and strengthens bone density. Although experts classify testosterone as a steroid hormone, the term can cause confusion. People often mistake it for synthetic anabolic steroids, which are artificially created to mimic testosterone’s effects for performance enhancement.

Testosterone is technically an anabolic steroid. What makes it different from synthetic anabolic steroids that are misused for performance enhancement is how it functions in the body.

This article explores testosterone's role as a naturally occurring anabolic androgenic steroid (AAS). It also investigates how testosterone differs from exogenous anabolic steroids commonly abused in athletics. Understanding the differences between testosterone replacement therapy (TRT) that is medically supervised and unregulated steroid use is essential for informed decision-making.

Key Takeaways

  • Testosterone is a steroid hormone.
  • It is vital for male health, including the development of male genitals, lean muscle growth, sexual function, mood, and metabolic regulation.
  • TRT is a medically supervised intervention for men who have clinically low testosterone.
  • Synthetic anabolic steroids used in performance enhancement are typically administered in excessive doses and carry health risks.
  • Context, dosage, and supervision by a medical professional will determine whether testosterone is therapeutic or potentially harmful.

Understanding Hormones and Anabolic Steroids

Hormones are chemical messengers produced by glands in the endocrine system. They travel through the bloodstream to tissues and organs and regulate functions such as metabolism, growth, mood, and sexual development.

Testosterone is one such hormone. It belongs to a category of steroids known as anabolic androgenic steroids.

  • Anabolic refers to its tissue-building effects, especially promoting protein synthesis and muscle growth.
  • Androgenic refers to testosterone as a male sex hormone and its role in the development and maintenance of male characteristics.

Biochemically, all steroids (including testosterone) share a common structural feature: a core of four fused carbon rings. This includes sex hormones like testosterone and estrogen, and other substances like vitamins and alkaloids, such as cholesterol.

What Is Testosterone?

Testosterone is a naturally occurring hormone produced mainly in the testes in males and in smaller amounts by the ovaries in females and the adrenal glands in both sexes. Testosterone is instrumental in:

  • Building lean muscle mass and physical strength
  • Maintaining bone mineral density
  • Regulating libido and improving sexual dysfunction
  • Supporting mental health, including motivation and focus
  • Maintaining body hair growth and male physical appearance
  • Managing red blood cell production and metabolic health

Testosterone levels peak in adolescence and early adulthood, then naturally decline with age. The natural decline of testosterone levels is a normal part of aging and doesn't always cause noticeable symptoms.

The Truth About Low Testosterone Levels

Some men do not produce testosterone levels that are high enough to maintain physiological and cognitive wellness. They may experience symptoms when testosterone levels fall below the clinical threshold (less than 300 ng/dL), leading to male hypogonadism, or clinically low testosterone.

Low testosterone is otherwise known as a testosterone deficiency, a medical condition associated with fatigue, loss of libido, depression, reduced muscle mass, and other impairments that affect quality of life.

Testosterone vs. Synthetic Anabolic Steroids

If testosterone is a steroid, how is it different from anabolic steroids that have such a bad reputation? This is where much of the confusion lies.

Testosterone is a steroid by chemical definition, so people often group it with the anabolic steroids used to boost physical performance.

Here’s the distinction:

  • Doctors administer testosterone treatment in physiologic doses during medically supervised therapy to address symptoms of low testosterone. These doses aim to restore testosterone levels to a healthy range.
  • Anabolic steroids: According to the United States Drug Enforcement Agency (DEA), they are administered in supraphysiological doses to boost athletic performance, which means they can be 10 to 100 times higher than therapeutic levels.

Anabolic Steroids: Abuse and Risks

The misuse of anabolic steroids (when taken in high doses to enhance athletic performance without the supervision of a medical professional) for aesthetic or competitive purposes is associated with a range of adverse effects. The National Institute on Drug Abuse (NIDA) cites an extensive list, including:

  • Cardiovascular disease
  • Liver disease and damage
  • Mood disorders and aggression
  • High blood pressure
  • Increased risk of prostate issues, including prostate cancer
  • Severe acne

Understanding Testosterone Replacement Therapy (TRT)

TRT is a clinically validated treatment approach for men suffering from low testosterone. It involves restoring low testosterone levels to the normal physiological range.

Testosterone replacement therapy can be administered via testosterone injections, pills, transdermal patches, pellets, or topical gels.

The Benefits of Testosterone Therapy

When properly administered, the hormone testosterone can:

  • Improve symptoms like fatigue and low libido
  • Increase muscle mass and reduce body fat, counteracting weight gain
  • Support bone density and cardiovascular health
  • Improve mood and cognitive function

It's important to note that testosterone replacement therapy is not the same as anabolic steroid abuse. Testosterone replacement therapy is prescribed, monitored, and adjusted based on a patient's clinical profile, as indicated by a blood test.

Testosterone replacement treatment requires regular bloodwork to monitor safety markers such as red blood cell count, prostate-specific antigen (PSA), and lipid profiles.

Public Misconceptions About Testosterone Levels

Much of the confusion surrounding testosterone stems from its dual identity as both a naturally produced hormone and a substance abused in sport.

While both fall into the biochemical category of anabolic steroids, their context of use, dose, and intended outcomes are vastly different.

Here are some common myths:

  • “Testosterone therapy is just a legal form of steroids.” - No. Medical testosterone therapy is prescribed at therapeutic doses to achieve normal testosterone levels. It aims to restore normal hormonal function.
  • “Natural testosterone and synthetic anabolic steroids are equally harmful.” - False. Endogenous testosterone is central to male health. Misusing synthetic variants without medical supervision is harmful.
  • “If I increase testosterone, I’ll become aggressive or ‘roid rage’ prone.” - Also false. Research shows that physiological doses of testosterone do not lead to increased aggression or hostility. Balanced testosterone levels may promote mental stability and well-being.

The Bottom Line: Context is Everything

To answer the question: yes, testosterone is a steroid because it fits the definition biochemically. It is an anabolic androgenic steroid that is produced naturally in the human body. However, not all steroids are bad, particularly when they are used for legitimate medical purposes.

The stigma around the word "steroid" has been generated by men who misuse anabolic steroids. Equating therapeutic testosterone replacement with illicit steroid use is scientifically inaccurate and potentially harmful to men who need help for genuine hormonal imbalances.

Knowing the difference between medically supervised hormone therapy and anabolic steroid abuse is crucial for making informed health decisions.

References

  1. National Institutes of Health (NIH). Testosterone. U.S. National Library of Medicine, MedlinePlus.
  2. Mayo Clinic Staff. Testosterone therapy: Potential benefits and risks as you age.
    Mayo Clinic.
  3. United States Drug Enforcement Administration (DEA). Anabolic Steroids Fast Facts.
  4. Endocrine Society. Testosterone Therapy in Men with Hypogonadism: An Endocrine Society Clinical Practice Guideline.
    The Journal of Clinical Endocrinology & Metabolism, 2018.
  5. World Health Organization (WHO). Anabolic Steroid Abuse and Public Health.

National Institute on Drug Abuse (NIDA). Anabolic Steroids DrugFacts.

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